Paradigm Shift in the Management of Isolated Interrupted Aortic Arch in Adulthood

Firouzi, Ata; Sadeghipour, Parham; Pouraliakbar, Hamidreza; Shafe, Omid; Moosavi, Jamal; Mohebbi, Bahram; Abdi, Seifollah; Alemzadeh‐Ansari, Mohammad Javad; Khajali, Zahra; Saedi, Sedigheh; Hosseini, Zahra

doi:10.1016/j.cpcardiol.2020.100717

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…The pulsation of lower or up extremity artery may be helpful but it depends on the position of the interruption. Systolic ejection murmurs are audible in the interscapular areas 40 . Among those 25 adult cases with isolated IAA, almost all patients suffered from hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…21,22 It is difficult to identify such patients unless discrepancy between the blood pressure of the upper and lower extremities is found or echocardiography is performed. 40 The pulsation of lower or up extremity artery may be helpful but it depends on the position of the interruption. Systolic ejection murmurs are audible in the interscapular areas.…”

Section: Discussionmentioning

confidence: 99%

“…Systolic ejection murmurs are audible in the interscapular areas. 40 Echocardiography is a useful initial screening method, particularly important for neonates, to identify and measure necessary anatomical data of IAA, and identify other cardiac malformations. 2,43 Computated tomography angiography provides a high resolution three-dimensional image of IAA and collateral vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Other common symptoms include a large pressure differential between upper and lower extremities, claudication, and CHF 21,22 . It is difficult to identify such patients unless discrepancy between the blood pressure of the upper and lower extremities is found or echocardiography is performed 40 . The pulsation of lower or up extremity artery may be helpful but it depends on the position of the interruption.…”

Section: Discussionmentioning

confidence: 99%

“…Cases reports of percutaneous recanalization and stenting have already been published before and this patient was known with suffering from aortic coarctation in childhood. 39,40 The incidence rates of hazardous complications such as aortic dissection, perforation is high and immediate access to cardiac surgery must be available. 29 For isolated type in adult, extra-anatomic bypass from the ascending and descending aorta is the most welcome.…”

Section: T a B L E 1 Clinical Details Of The Three Patientsmentioning

confidence: 99%

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Is surgery necessary for adults with isolated interrupted aortic arch?: Case series with literature review

Jiang

Wang

Jiang

et al. 2021

Journal of Cardiac Surgery

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Background and Aim: Interrupted aortic arch (IAA) is defined as a complete interruption of aortic lumen between the ascending and descending aorta. It is an uncommon and complicated congenital heart disease. It is rare for patients with isolated IAA to survive to adulthood without operation. Here we present three rare cases with isolated IAA together with a review of the literature of IAA. Besides, we reviewed reported adult cases with isolated IAA in the last 20 years and summarized the relevant data of the isolated type.Methods: We retrospectively searched the hospital databases for adult patients with isolated IAA diagnosed at the Wuhan Union Hospital over the past 10 years.Cases related to adult isolated IAA published in last 20 years were identified by searching Pubmed.Results: Three adult patients with isolated IAA were identified. Two were referred to us for hypertension management and were diagnosed with IAA. They declined surgical treatments and took antihypertensive medications. One patient was referred to our hospital for further treatment options after diagnosed with IAA at another hospital. He received an extra-anatomic bypass surgery. But his hypertension did not well resolve after surgery, and was subsequently managed by anti-hypertensives medications. 25 published adult patients with isolated IAA were identified in Pubmed and relevant details were summarized.Conclusions: Adult patients with isolated IAA usually have extensive collateral vessels joining the descending aorta. Anti-hypertensives medical management with long-term follow-up appears to be a reasonable treatment option for these patients, although surgical intervention is a good choice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%