Coarctation of Persistent Fifth Aortic Arch With Interrupted Fourth Arch: First Pediatric Report of Stent Intervention

Valderrama, Paulo; Álvarez, Teresa; Ballesteros, Fernando; Rodrı́guez, Alejandro; Zunzunegui, José Luis

doi:10.1016/j.rec.2015.10.021

Cited by 7 publications

(17 citation statements)

References 5 publications

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“…For most PFAA patients, the main surgical needs are resection of the narrow part or ligation of the fifth arch to reconstruct the fourth arch, [ 26 ] patch enlargement of the arch stenosis, [ 27 ] and patch augmentation of the fifth arch to replace the fourth arch, [ 28 ] sometimes using Gore-Tex tube grafts [ 29 ] or stenting. [ 30 ] The surgical method of choice depends on the associated CHD and the hemodynamic change. Uysal et al [ 31 ] recently reported the first case of PFAA with CoA treated with balloon angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Assessment of persistent fifth aortic arch by echocardiography and computed tomography angiography

Yang

Zhu

et al. 2020

Medicine

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To evaluate the utility of echocardiography (echo) in the diagnosis of persistent fifth aortic arch (PFAA), a very rare congenital aortic arch anomaly, and to compare echo and computed tomography angiography (CTA) imaging findings to improve our understanding of this anomaly. Data on the clinical diagnosis, imaging findings, and clinical management of PFAA were retrospectively analyzed in 10 suspected cases of PFAA admitted to our hospital between January 2012 and February 2017. We compared echo as a first line examination modality, and CTA and surgery results as the gold standard. Weinberg's classification was used to classify the type of PFAA. All patients (100%) received echo examination, eight patients (80%) received CTA examination, and four patients (40%) received sternotomy surgery; all recovered well after surgery. According to Weinberg's classification, 2, 6, and 2 cases (20%, 60%, and 20%) were classified as Type A, B, and C, respectively. Echo was able to diagnose 5 cases of PFAA (1 Type A case and 4 Type B cases) in the first instance. The diagnostic conformance rate of echo was 62.5% after comparisons with CTA and surgery results. The clinical manifestation of PFAA was atypical, and its diagnosis depended primarily on medical imaging. Echo has a relatively high diagnostic accuracy for PFAA, which is very valuable for its early detection.

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Section: Discussionmentioning

confidence: 99%

Assessment of persistent fifth aortic arch by echocardiography and computed tomography angiography

Yang

Zhu

et al. 2020

Medicine

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“…Both surgery and interventional treatment have been reported for persistent 5th aortic arch with coarctation 4 , 5 , 8 , 12 . Considering the highly invasive nature of surgery in the presence of the possible numerous collateral arteries in the chest especially in an adult cohort, stent implantation can be a favourable alternative.…”

Section: Discussionmentioning

confidence: 99%

A case report: stent implantation to treat coarctation of persistent 5th aortic arch associated with interrupted 4th aortic arch

Kato

Ohashi

Nishikawa

2019

European Heart Journal - Case Reports

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Background Persistent 5th aortic arch is a rare cardiac anomaly that is usually surgically corrected during infancy or early childhood if it is associated with coarctation of the aorta. Here, we report an adult with coarctation of the 5th aortic arch who was successfully treated by stent implantation. Case summary An asymptomatic 32-year-old woman presented with hypertension and a significant arm–leg difference in pressure. On suspicion of coarctation of the aorta, a chest computed tomography was performed, leading to a diagnosis of an interrupted 4th aortic arch with coarctation of a persistent 5th aortic arch. Percutaneous catheter intervention using a PALMAZ large stent dilated to 12 mm resulted in a minimal peak-to-peak pressure gradient. The patient was discharged home after a 2-day monitoring without hypertension and arm–leg blood pressure difference. She remained normotensive with a patent aortic arch on echocardiography performed 10 months after treatment. Discussion As for simple coarctation of the aorta, stent implantation was feasible and effective in an adult patient with coarctation of the 5th aortic arch.

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“…1 Since then, several case reports have been published describing this anomaly. [3][4][5][8][9][10] The persistent fifth aortic arch can be either right sided or left sided and is subdivided into two major classes. The first one is a systemic-to-systemic connection (types A and B), which is the most common one.…”

Section: Discussionmentioning

confidence: 99%

“…Several types of surgical and catheter-based interventions have been described in the literature. 2,[4][5][6]8 In type C, a systemic-topulmonary shunt is necessary to be able to come off prostaglandins. 10 In our case, the discovery of the anomaly intra-operatively mandated our surgical approach.…”

Section: Discussionmentioning

confidence: 99%

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Aortic arch advancement for type A interrupted aortic arch with persistent fifth aortic arch type B

2017

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Persistence of the fifth aortic arch is a very rare anomaly, but is clinically relevant when it is associated with coarctation. We report a case of a neonate with type A interrupted aortic arch and severe coarctation of a persistent fifth aortic arch, which was discovered after repair of a left congenital diaphragmatic hernia. The combination of anomalies was discovered intra-operatively following left thoracotomy, and was treated with aortic arch advancement. The postoperative course was uneventful.

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Coarctation of Persistent Fifth Aortic Arch With Interrupted Fourth Arch: First Pediatric Report of Stent Intervention

Cited by 7 publications

References 5 publications

Assessment of persistent fifth aortic arch by echocardiography and computed tomography angiography

Assessment of persistent fifth aortic arch by echocardiography and computed tomography angiography

A case report: stent implantation to treat coarctation of persistent 5th aortic arch associated with interrupted 4th aortic arch

Aortic arch advancement for type A interrupted aortic arch with persistent fifth aortic arch type B

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