Successful total repair of interrupted aortic arch associated with ventricular septal defect and large patent ductus arteriosus

Losman, Jacques G.; Joffe, Hymie S.; Beck, Walter; Barnard, Christiaan N.

doi:10.1016/0002-9149(74)90620-1

Cited by 15 publications

(4 citation statements)

References 13 publications

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“…Therefore early recognition of the lesion is vital as surgical correction is possible (Tyson et al, 1970;Barratt-Boyes et al, 1972;Murphy et al, 1973;Losman et al, 1974;Trusler and Izukawa, 1975;Fishman et al, 1976;Ventemiglia et al, 1976;Monro et al, 1977). Origin of the right subclavian artery from the descending aorta has been reported with interruption of a left aortic arch (Evans, 1933;Kleinermann et al, 1958;Tabakin andHanson, 1960, Zetterqvist, 1967;Morgan et al, 1970;Van Praagh et al, 1971;Subramanian, 1972;Kauffet al, 1973;Murphy et al, 1973;Trusler and Izukawa, 1975).…”

Section: Discussionmentioning

confidence: 99%

Aortic arch interruption presenting with absence of all limb pulses.

Sharratt¹,

Leanage²,

Monro³

et al. 1979

Archives of Disease in Childhood

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SUMMARY Three patients with aortic arch anomalies presented with severe heart failure, acidaemia, and poor or absent upper and lower limb pulses. Prominent carotid arterial pulsations were detected which distinguished the condition clinically from aortic atresia. In 2 patients with a left aortic arch, interruption was distal to the left common carotid artery and there was an aberrant right subclavian. In the 3rd patient with a right aortic arch, interruption was distal to the right common carotid and there was an aberrant left subclavian artery. By dilating the narrowed ductus, prostaglandin E2 infusion corrected the acidosis. Successful surgical correction was achieved in one patient by direct anastomosis of descending aorta to ascending aorta and the base of the left common carotid artery.Complete interruption of the aortic arch is a rare congenital anomaly which normally presents in infancy with heart failure and acidaemia (Fishman et al., 1976). There is almost always a ventricular septal defect and persistence of the ductus arteriosus (Roberts et al., 1962). When the interruption is between the left common carotid artery and the left subclavian artery (type B of Celoria and Patton (1959)), the descending aorta is supplied from the pulmonary artery via the ductus arteriosus and also by retrograde flow from the left vertebral artery, which also supplies the left subclavian artery.When an infant presents with cyanotic congenital heart disease, heart failure, acidaemia, and reduced or absent upper and lower limb pulses the diagnosis of aortic atresia is likely. With type B interruption of the aortic arch, when the right subclavian artery arises aberrantly from the descending aorta, and the ductus arteriosus constricts (Fig. 1), a similar clinical picture is found. In this case, however, there will be normal or bounding carotid pulses. This is now a surgically correctable lesion and hence the importance of its recognition. We report 2 cases that presented in this manner, and a further similar patient with a right-sided aorta, grossly hypoplastic arch distal to the right common carotid, and aberrant left subclavian artery.

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Section: Discussionmentioning

confidence: 99%

Aortic arch interruption presenting with absence of all limb pulses.

Sharratt¹,

Leanage²,

Monro³

et al. 1979

Archives of Disease in Childhood

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“…There is a high mortality rate (approximately 50%), whichever method is used. Primary intracardiac repair of coexisting lesions has been successfully carried out in four of seven cases reported [1,10,11,15], the most commonly associated lesions being defect(s) of the ventricular septum. Palliation carries a lower morbidity and mortality than complete repair and most surgical attempts at complete repair are unsuccessful and unreported.…”

Section: Surgical Management Of Arch Interruptionmentioning

confidence: 99%

Complex transposition with interrupted right aortic arch and partial Di George syndrome: Successful palliation with combined medical and surgical therapy

et al. 1984

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A five-day-old infant with transposition of the great arteries, ventricular septal defect, and an interrupted right aortic arch underwent successful balloon septostomy, pulmonary artery banding, and aortic arch repair. The infant also had abnormal facies with severe refractory hypocalcemia and depressed T-lymphocyte number and function believed to represent a partial Di George syndrome. The hypocalcemia resolved following treatment with a vitamin-D analogue, T-cell number increased, and T-cell function improved, but both remained subnormal.

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“…Aus der Weltliteratur (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) sind uns ingesamt 210 Fälle bekannt, von denen 28 erfolgreich chirurgisch behandelt werden konnten (s. Tabelle). Die UAB ist fast immer mit Herzmißbildungen vergesellschaftet.…”

Section: Zusammenfassungunclassified

“…Die von uns durchgeführte gleichzeitige Korrektur des fehlenden Aortenbogens und des begleitenden Herzfehlers wurde bislang nur in 4 Fällen vorgenommen (11,13,17,20). Unser chirurgisches Vorgehen bestand in einer Überbrückung der Unterbrechung durch Einpflanzen des proximalen Stumpfes der linken Arteria subclavia in die Aorta ascendens, was bisher nicht beschrieben wurde.…”

Section: Zusammenfassungunclassified

Unterbrechung des Aortenbogens mit Fallot'scher Tetralogie

Manouguian¹,

Bjørnstad²,

Rastan³

1975

Thorac cardiovasc Surg

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In a ten year old girl, a combination of interruption of the aortic arch (IAA) and tetralogy of Fallot was corrected simultaneously using cardiopulmonary bypass. The interruption was bypassed by implantation of the proximal end of the left subclavian artery into the ascending aorta. The simultaneous correction of both malformations was possible by a left anterolateral transsternal thoracotomy. The success of this operation was confirmed by cardiac cathetherization and angiography. As far as we know this the first report of a successful simultaneous correction of this unusual combination of cardiac malformations.

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Successful total repair of interrupted aortic arch associated with ventricular septal defect and large patent ductus arteriosus

Cited by 15 publications

References 13 publications

Aortic arch interruption presenting with absence of all limb pulses.

Aortic arch interruption presenting with absence of all limb pulses.

Complex transposition with interrupted right aortic arch and partial Di George syndrome: Successful palliation with combined medical and surgical therapy

Unterbrechung des Aortenbogens mit Fallot'scher Tetralogie

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