Anomalous origin of the left vertebral artery from the aortic arch

Einstein, Evan Hy; Song, Linda; Villela, Natalia Luisa Arias; Fasani-Feldberg, Gregory Brian; Jacobs, Jonathan L.; Kim, Dolly O.; Nathawat, Akshay; Patel, Devika; Bender, Roger B.; Peters, Daniel F.

doi:10.12945/j.aorta.2016.15.022

Cited by 11 publications

(13 citation statements)

References 6 publications

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“…So the prevalence rate comes to 14.8 %, and concluded that this anomaly is more prevalent than thought earlier, and may have implications for surgical practice. (10) We also noted this finding in one of our cases. A series of 216 patients with TOF was investigated by catheterization, and post catheterization analysis was done by Sadia Saeed et al They found Pulmonary Artery (PA) abnormalities in 84 (38.9%) patients.…”

Section: Aberrant Vesselssupporting

confidence: 75%

Stratification of Tetralogy of Fallot and Status of Pulmonary Artery by Cardiac CT (Pulmonary Angiography)

Sarawagi¹,

Sodani²,

Sodani³

et al. 2019

jemds

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BACKGROUND One of the important causes of morbidity and mortality in paediatric population is Congenital Heart Disease (CHD). Genetic, environmental and cultural factors may lead to variability in prevalence and incidence. (1) There are many modalities for the diagnosis of CHD, in our armamentarium. Echocardiogram is the first in cases suspicious of CHD. However quite often, it is difficult to access and evaluate great arteries, pulmonary veins, coronary arteries and intracardiac anomalies in detail. In seriously ill or uncooperative patients, magnetic resonance imaging (MRI) is often of limited use. MRI examination also takes longer duration, causes claustrophobia and electronic devices such as pacemakers are a contraindication. (2) METHODS In this retrospective observational study 21 cases of clinically diagnosed Tetralogy of Fallot's (TOF) referred to Sodani Diagnostic Centre, Indore and matching our inclusion and exclusion criteria, were included in this study. Out of 21 subjects, 9 were female and 12 were male. Youngest was 9 months old and eldest was 30 years old. Most of the study subjects were sent investigation of the morphology of heart and great vessels using cardiac CT, as echocardiography was not enough. All studies were performed on 128 Slice GE Optima after taking consent. RESULTS In our study, a 128 slice multidetector CT scanner GE Optima was used, to scan 21 patients with TOF. Defect in ventricular septum (VSD) was noted in all cases (n =21). Overriding of aorta was noted in nineteen patients (90%). Right ventricle was mildly hypertrophied (RVH) in 10 patients (47%). 8 patients (33%) were showing major aorto-pulmonary collateral circulation (collateral diameters ranged from 1 to 3.5 mm) and narrowing of pulmonic infundibulum was seen in 7 patients (28%), aortic arch was right sided in 5 cases (23%). Complex pulmonary artery morphology was seen in most of the patients. Pulmonary trunk and bilateral pulmonary arteries were significantly narrowed in 3 cases (14%). Stenosis of main trunk and left pulmonary artery were noted in 2 cases (9%). Right pulmonary artery and main trunk narrowing was seen in 4% (n=1). CONCLUSIONS Important additional information is obtained by using technically advanced Multidetector CT. Newer advances have significantly increased the speed of CT machines, so we can complete the procedure of pulmonary CTA with ease of peripheral venous access and markedly reduced sedation time. No correlation was found between size of pulmonary trunk and collaterals, which suggests that every patient has different chance of detecting collaterals. However as age increases, chances of getting collaterals also increases.

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Section: Aberrant Vesselssupporting

confidence: 75%

Stratification of Tetralogy of Fallot and Status of Pulmonary Artery by Cardiac CT (Pulmonary Angiography)

Sarawagi¹,

Sodani²,

Sodani³

et al. 2019

jemds

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“…Budhiraja et al (2013) [8] assumed that the first part of VA could be the preserved left sixth segmental artery, or there might be a large absorption of the embryonic tissue of LSCA, between the origin of the AA to the origin of VA, causing direct origin of the LVA from the AA. The sixth cervical intersegmental artery customarily vanishes, but Einstein et al (2016) [15] supposed that it might have maintained, permitting blood flow from the arch of aorta. The cause of origin of the LVA from the AA might be the decreased blood flow through the normal origin of the LVA which is the dorsal division of the seventh cervical intersegmental artery.…”

Section: Discussionmentioning

confidence: 99%

Vertebral artery variations revised: origin, course, branches and embryonic development

et al. 2021

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Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via Pubmed database, using the terms; "variations of vertebral artery AND cadaveric study", "variations of vertebral artery AND cadavers" and "anomalies of vertebral artery AND cadavers". Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different population, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area.

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“…The relatively benign nature of this anatomical variation may be contributing to an underestimated frequency. However, the fact that this variant appears to be more frequent in females than males [2] and as sex-based differences in pain perception by medical professionals has been recorded [12] we must consider the possibility that this variant underlies conditions that are being overlooked by health care providers. Improving our understanding of the frequency of this variant and educating health care practitioners to its possible presence could improve the quality of health care for many people.…”

Section: Discussionmentioning

confidence: 99%

“…I n typical human anatomy, the vertebral arteries (VA) originate from the subclavian arteries (SCA), enter the transverse foramen of the sixth cervical vertebra (C6), and travel within the subsequent more superior transverse foramina to enter the skull via the foramen magnum, and provide circulation to the posterior brain. Reported frequencies of VAs with aberrant origins vary widely, and have been reported in anywhere from 5 to 50% of the population [1][2][3]. Of those, left vertebral artery (LVA) variants are most common, appearing in approximately 2 to 7% of the population (as reported in a recent aggregation of studies) [1].…”

Section: Introductionmentioning

confidence: 99%