Isolated left brachiocephalic artery with the right aortic arch

Dubey, Gajendra; Gupta, Saurabh Kumar; Ss, Kothari

doi:10.4103/0974-2069.197067

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…[1] However, later, some authors defined ILBA as origin of LBA from left PA through an AD. [5] Review of literature and study of our case, who had no connection of LBA to PA, indicate the shortcoming of the current definition in inclusion of all cases of ILBA. Obviously, there is significant hemodynamic difference between patients with PAD and those with obliterated AD.…”

Section: Shortcomings Of the Current Terminology And Definition And Tmentioning

confidence: 87%

“…There are confusing inconsistencies not only in terminology but also in the definition of isolation of LBA in the literature. Different terminologies have been used for this anomaly including “anomalous origin of LBA from pulmonary artery,” “aplasia of left brachiocephalic trunk,” “isolation,” “anomalous origin of LBA from left pulmonary artery,” and “origin of LBA from right pulmonary artery.”[23456] The term “origin” from PA is not justified because the direction of blood flow is not from PA into the LBA. This hemodynamic point differentiates ILBA from interrupted aortic arch Type C [Figure 1 and Table 1].…”

Section: Shortcomings Of the Current Terminology And Definition And Tmentioning

confidence: 99%

“…This anomaly is defined as the absence of connection of the left brachiocephalic artery (LBA) to aortic arch and connection of LBA to pulmonary artery (PA) through an arterial duct (AD). [123456] However, this definition is not inclusive of all cases, including our present case. We present an asymptomatic child with ILBA and without connection of LBA to PA.…”

Section: Introductionmentioning

confidence: 96%

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Isolation of the left brachiocephalic artery revisited: A 52-year literature review and introduction of a novel anatomic-clinical-prognostic classification

Rad

Pouraliakbar

2019

Ann Pediatr Card

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Isolation of the left brachiocephalic artery (ILBA) is an extremely rare anomaly of aortic arch with diverse manifestations in the neurologic system, heart, and left upper arm. This anomaly is defined as the absence of connection of the left brachiocephalic artery (LBA) to aortic arch and connection of LBA to pulmonary artery (PA) through a patent arterial duct (PAD). However, this definition is not inclusive of all cases. Not only are there inconsistencies in the definition and terminology of this aortic arch anomaly but also there is no classification for this anomaly despite its heterogeneous nature in terms of anatomy, clinical presentation and prognosis. We performed a 52-year comprehensive literature review in the period between 1966 and 2018. Our inclusion criteria were any manuscript that included a case report or case series, with confirmed diagnosis of ILBA. All quantitative data were analyzed using descriptive analysis by SPSS version 21 (IBM SPSS Statistics, USA). Results were presented as mean ± standard deviation and median. Based on the presence or absence of connection of LBA to PA and the number of sources of steal from the LBA, we classified ILBA into three types: single-steal type with no connection of LBA to PA and single source of blood flow steal from LBA through the left subclavian artery (LSCA), double-steal type with connection of LBA to PA through PAD and two sources of steal through LSCA and arterial duct (AD), and triple-steal type with bilateral PADs and therefore, three sources of blood flow steal from LBA including the LSCA and the double ADs. Patients with single-steal type have the best prognosis and present latest with symptoms of cerebrovascular insufficiency or left arm claudication. The oldest reported patient was 69 years of age with symptoms of dizziness and near syncope. No death was reported in these patients. Double-steal type is the most common type and is often associated with genetic syndromes and/or extracardiac anomalies. Triple-steal type is the rarest type with the earliest presentation and worst prognosis. The oldest reported patient was 60 days of age. All reported cases had cardiac symptoms, pulmonary overcirculation, pulmonary hypertension, and fatal outcome.

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Section: Shortcomings Of the Current Terminology And Definition And Tmentioning

confidence: 87%

Section: Shortcomings Of the Current Terminology And Definition And Tmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Isolation of the left brachiocephalic artery revisited: A 52-year literature review and introduction of a novel anatomic-clinical-prognostic classification

Rad

Pouraliakbar

2019

Ann Pediatr Card

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“…2 We postulated that our patient had a right aortic arch with mirror-image branching with the exceptions of the incompletely regressed left branch of aortic sac and left patent ductus arteriosus. There are several case reports of isolated left innominate artery due to the interruption of the left branch of the aortic sac 3,4,5,6,7 ; however, to the best of our knowledge, there is only one case report on incomplete isolation of the left innominate artery. 8 In our patient, pulmonary stenosis worsened over time in the setting of aggravating right ventricular outflow obstruction; the pulmonary blood flow was solely delivered via the left carotid artery and the narrow connection between the ascending aorta and the left innominate artery when she underwent surgery.…”

Section: Discussionmentioning

confidence: 99%

Incomplete isolation of the left innominate artery from the right aortic arch: a rare case of double-outlet right ventricle with pulmonary stenosis

2019

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Isolation of the left innominate artery from the right aortic arch is a rare anomaly. Herein, we present an even rarer case of incomplete isolation of the proximal left innominate artery with the right aortic arch in a 3-month-old female infant with a double-outlet right ventricle and pulmonary stenosis. Surgical repair at 6 months of age was successful, leading to the restoration of adequate flow in the left arm.

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“…A right aortic arch with complete isolation of the left innominate artery is rare and sometimes associated with genetic conditions, including additional intracardiac defects. 1 This is the first report of right aortic arch with complete isolation of the left innominate artery associated with global cerebral white matter atrophy.…”

mentioning

confidence: 81%

A case of right aortic arch with isolated left innominate artery and global cerebral white matter atrophy

Binka¹,

Sun

Gailloud

et al. 2019

Cardiol Young

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Isolated left brachiocephalic artery with the right aortic arch

Abstract: We report a case of isolation of the left brachiocephalic artery with the right aortic arch in a 9-year-old male child masquerading as large patent ductus arteriosus with left-to-right shunt. We have emphasized the subtle clinical findings which served as clues to the diagnosis.

Cited by 8 publications

References 13 publications

Isolation of the left brachiocephalic artery revisited: A 52-year literature review and introduction of a novel anatomic-clinical-prognostic classification

Isolation of the left brachiocephalic artery revisited: A 52-year literature review and introduction of a novel anatomic-clinical-prognostic classification

Incomplete isolation of the left innominate artery from the right aortic arch: a rare case of double-outlet right ventricle with pulmonary stenosis

A case of right aortic arch with isolated left innominate artery and global cerebral white matter atrophy

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