The development and anomalies of the aortic arch and its branches. With the report of a case of right cervical aortic arch and intrathoracic vascular ring

Harley, H. R. S.

doi:10.1002/bjs.18004620003

Cited by 47 publications

(17 citation statements)

References 23 publications

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“…The 4 previously reported patients (Beavan and Fatti, 1947;Harley, 1959;Gravier, Vialtel, and Pinet, 1959;Massumi, Weiner, and Charif, 1963) and one of ours were strikingly similar (Table IV; Case 1) and were associated with certain unusual anatomical and clinical features (Fig. 5).…”

Section: Circumflex Retro-oesophageal Aortic Archsupporting

confidence: 74%

“…The first branch given off by the aorta was the left common carotid artery; it originated from the ascending aorta in all cases. The right subclavian and either both right external and internal carotid arteries (our case; Beavan and Fatti, 1947), or a right common carotid artery (Harley, 1959), arose separately from the apex of the arch, except in one case in which a right brachiocephalic trunk was present (Gravier et al, 1959). The common carotid artery was atretic in another case (Massumi et al, 1963).…”

Section: Circumflex Retro-oesophageal Aortic Archmentioning

confidence: 74%

“…Of the 6 reported patients with a cervical right aortic arch, 3 had symptoms of tracheo-cesophageal compression (Beavan and Fatti, 1947;Harley, 1959;Massumi et al, 1963). This was caused by a vascular ring consisting of the right circumflex aortic arch, the left ligamentum arteriosum, and the pulmonary artery.…”

Section: Circumflex Retro-oesophageal Aortic Archmentioning

confidence: 99%

“…Another possibility is that the fourth right arch par-takes in the formation of the arch of the aorta, but for some unaccountable reason it fails to migrate into the thorax. One would have to postulate, in addition, that the right ductus caroticus persists, to explain why the right internal and external carotid arteries arise separately from the aorta (Harley, 1959). A third possible theory is that the right third and fourth arterial arches become confluent at a phase when the primitive arches are cervically located, perhaps due to anomalous growth of the pharyngeal pouch tissue in that area.…”

Section: Seg Sugc Avianmentioning

confidence: 99%

See 3 more Smart Citations

Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Hastreiter¹,

D’Cruz²,

Cantez³

et al. 1966

Heart

306

152

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Section: Circumflex Retro-oesophageal Aortic Archsupporting

confidence: 74%

Section: Circumflex Retro-oesophageal Aortic Archmentioning

confidence: 74%

Section: Circumflex Retro-oesophageal Aortic Archmentioning

confidence: 99%

Section: Seg Sugc Avianmentioning

confidence: 99%

See 2 more Smart Citations

Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Hastreiter¹,

D’Cruz²,

Cantez³

et al. 1966

Heart

306

152

View full text Add to dashboard Cite

“…The most common rings are double aortic arch and right-sided aortic arch with the ring being completed by a persistent ductus arteriosus ligament or mixtures of ligaments and Kommerel's diverticulum. Anatomical variations are very common with this group of disorders as are associations with genetic disorders such as Di Georges Syndrome [37][38][39]. Pulmonary artery sling (PAS) is another cause of stridor in the ring and sling category but the stridor is due to associated tracheal stenosis, malacia-stenosis and often pericarinal bronchial abnormalities.…”

Section: Tracheomalacia and Vascular Ringsmentioning

confidence: 98%

Stridor in the Neonate

Brent Masters

2011

CPR

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Stridor in the neonate is a sign that necessitates a basic physiological approach to establish a diagnosis. This includes a detailed assessment of the characteristics of the stridor; its associated features particularly voice quality, swallow, cough as well as general features and finally the levels of respiratory distress. The differential diagnosis is wide ranging, the associated features are common and the associated distress is highly variable. Common disorders causing stridor in the neonate include laryngomalacia, tracheobronchomalacia disorders, subglottic stenosis, and cysts; while vocal cord immobility, clefts, webs, hemangiomas and masses are rare. Diagnostic laryngoscopy and bronchoscopy are required in many cases.Management ranges from observation and parental education in mild cases to relief of hypoxia, relief or removal of obstruction and treatment of the specific causes through surgical means in the severe and potentially dangerous. A specialized chronic illness teamwork approach including medical, paramedical, psychological support for the child and family and otolaryngological and surgical teams is often required to ensure a satisfactory outcome. OVERVIEWStridor is a respiratory noise attributed to turbulent gas flow and other physical factors in the larynx or tracheal areas. Stridor is more often inspiratory in timing but expiratory and biphasic stridor also occur. Stridor is a relatively common sign confronting pediatricians however when present in the neonate it often causes considerable concern and anxiety because of its association with upper airway obstruction, respiratory distress, the ensuing diagnostic possibilities and the logistics and risks involved in affirming the diagnosis and instituting effective management. While the consequences of stridor as a sign are well understood by pediatricians and otolaryngologists, actually recognizing stridor is not necessarily easy for the broader range of general health care professions and parents as both alike often overlook it, underestimate it, confuse it with stertor, wheeze and other respiratory noises [1]. This may lead to delays in diagnosis, significant morbidity and even mortality. Combinations of noises such as stridor and wheeze, or stridor and "rattle" are also relatively common and may be confusing, yet they may still indicate the presence of important lesions. As the differential diagnosis is wide ranging from self resolving disorders to those with potentially life-threatening consequences, allocating the patient's symptoms and signs to a meaningful management process with the appropriate experience is required to ensure a safe approach to care. APPROACH TO STRIDORPatient history, contextual factors and focused histories invariably set the scene for diagnostic accuracy in clinical medicine. This is particularly the case for stridor in the neonate as appropriate management strategies generally flow from this point in most cases.The basic first principle premises for the accurate diagnosis of airway obstruction are that lesions causing...

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Right Cervical Aortic Arch With Left Descending Aorta

Shepherd¹

1969

Am J Dis Child

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THE NORMAL aortic arch is an intrathoracic structure derived embryologically from the left fourth branchial arch. In rare individuals, the aortic arch appears to be derived from the right third branchial arch. In such instances, the aortic arch extends well into the neck and the pattern of the brachiocephalic arteries is altered. This unusual anomaly manifests certain characteristic clinical findings. Report of a CaseA white female infant, delivered without incident after an uneventful, full-term gestation, appeared normal at birth and weighed 3,090 gm (6 lb 13 ounces). At 1 month of age, her weight was 3,508 gm (7 lb 11\m=3/4\ounces). The only abnormality found at that time, an inconstant systolic murmur heard along the left sternal border, was also heard at each monthly examination during the first year of life. At age 5 months, blood pressure was 116/60 mm Hg in the right arm and 122/84 mm Hg in the left San Francisco 94115 (Dr. Kerth).leg. Roentgenogram of the chest at 6 months was within normal limits. At lO1/^months, an electrocardiogram showed no abnormality other than incomplete right bundle branch block. The infant was suspected of having either a small atrial septal defect of the secundum type or mild stenosis of the pulmonic valve.The patient was lost to observation for more than a year. When she was seen again, at age 2% years, growth and development had con¬ tinued within normal limits, except that the left scapula had now become prominent and some winging could be detected; also, her neck appeared to be webbed. Roentgenograms showed lack of definition of the cervical spine and pos¬ sible spina bifida, compatible with Klippel-Feil anomaly. Buccal smears were positive for sex chromatin. The previously heard murmur was present as a grade 2 soft systolic murmur at the base; in addition, a pulsating mass was now detected over the base of the right carotid artery. A carotid aneurysm was suspected. The ECG findings at this time were normal. A chest roentgenogram showed a rather prominent aortic arch and persistent trachéal shift to the left in the cervical region (Fig 1 and 2). By age 3 years 3 months, a thrill was detected over the mass at the base of the neck on the right side; the underlying murmur was con¬ tinuous. When the pulsating mass was occluded by pressure, the pulse rate dropped from 120 to 60 beats per minute. Blood pressures were 100/50 mm Hg in the right arm, 95/70 mm Hg in the left arm, and 115/80 mm Hg in the left leg. One examiner detected a slight Horner's Downloaded From: http://archpedi.jamanetwork.com/ by a UQ Library User on 06/17/2015

show abstract

The development and anomalies of the aortic arch and its branches. With the report of a case of right cervical aortic arch and intrathoracic vascular ring

Cited by 47 publications

References 23 publications

Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Stridor in the Neonate

Right Cervical Aortic Arch With Left Descending Aorta

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