Interrupted aortic arch with post-interruption aneurysm and bicuspid aortic valve in an adult: a case report and literature review

Patel, Dhruv; Maldjian, Pierre D.; Lovoulos, Constantinos

doi:10.1016/j.radcr.2015.06.001

Cited by 26 publications

(27 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IAA may be associated with other congenital heart diseases like ventricular septal defect, PDA and bicuspid aortic valve. Type B is also associated with subaortic stenosis due to malalignment of outlet conal septum (71). IAA is generally seen in patients with 22q11 deletion syndrome, predominantly involving type B (69).…”

Section: Iaamentioning

confidence: 99%

Congenital anomalies of the aortic arch

Priya

Thomas

Nagpal

et al. 2018

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

Congenital anomalies of the aortic arch include diverse subgroups of malformations that may be clinically silent or may present with severe respiratory or esophageal symptoms especially when associated with complete vascular rings. These anomalies may be isolated or may be associated with other congenital heart diseases. Volume rendered computed tomography (CT) and magnetic resonance angiography (MRA) help in preoperative surgical planning by providing information about the complex relationship of aortic arch and its branches to the trachea and esophagus. Three dimensional capabilities of both computed tomography angiography (CTA) and MRA are helpful in determining evidence of tracheal or esophageal compression or other high-risk features in patients with a complete vascular ring.

show abstract

Section: Iaamentioning

confidence: 99%

Congenital anomalies of the aortic arch

Priya

Thomas

Nagpal

et al. 2018

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

show abstract

“…Interrupted aortic arch (IAA) is defined as a complete loss of luminal and anatomic continuity between ascending and descending parts of the aorta 1 . IAA is an uncommon congenital malformation of the aortic arch that occurs in 3 per million live births and accounts for only 1% of all congenital heart disease 1 . IAA is much more frequently encountered in the neonate, and immediate surgical intervention remains the only therapy.…”

Section: Introductionmentioning

confidence: 99%

“…As for IAA in adult patient, it is extremely uncommon with only 40 cases documented so far. Of the 40 reported adult patients with IAA, only 3 presented with congestive heart failure as IAA in the adult usually develops extensive collateral arteries 1–4 . IAA in adult patients can live for many years asymptomatically due to existence of extensive collateral arteries (CAs), and whether these patients should be treated medically or with surgical repair has not been determined.…”

Section: Introductionmentioning

confidence: 99%

Patient-specific Computational Hemodynamic Analysis for Interrupted Aortic Arch in an Adult: Implications for Aortic Dissection Initiation

Peng

Qiu

Yang

et al. 2019

Sci Rep

View full text Add to dashboard Cite

The guideline for the treatment of interrupted aortic arch (IAA) in adults has not been established although most centers tend to propose surgery. There is no clear evidence for the preferred selection of surgical repair versus conservatively medical treatment for the uncertain effects of both treatments. However, reports of sporadic aortic dissection (AD) of descending aorta (DAo) in IAA in adults before surgery drew our attention. It is quite perplexing because there seems to be no risk factors for the development of AD at DAo such as long-term uncontrolled hypertension, atherosclerosis, aortic aneurysm or genetic disorder. In this paper, we carried out the numerical investigation on the hemodynamics in a patient-specific IAA model, which was reconstructed from computed tomography images. Hemodynamic parameters including the flow pattern, pressure distribution, and wall shear stress (WSS) indicators were obtained. The simulation revealed that the jet flows from the collateral arteries (CAs) induced risk hemodynamic forces on the lumen wall including high time-averaged wall shear stress (TAWSS), high pressure and rapid change of WSS direction throughout the cardiac cycle. Moreover, it is found that only a jet flow which circumferentially washes out the aortic wall might cause tears on the wall. It is concluded that the specific geometrical features of the extensive major CAs might result in the risky hemodynamics leading to the initiation and development of AD in this particular IAA patient. CFD analysis in IAA can provide a clinical reference, and the results should be further studied in depth in the future.

show abstract

“…[6] In neonates, 53% of the cases are type B, followed by types A (43%) and C (4%). [7] However, the presentation of IAA in adulthood was obviously different. In a review of 38 cases of IAA in adulthood, 79% of these patients were type A, followed by types B and C with 16% and 3%, respectively.…”

Section: Discussionmentioning

confidence: 99%