Persistent fifth aortic arch

Subramanyan, Raghavan; Sahayaraj, Anto; Sekar, Prem; Cherian, K M

doi:10.1016/j.jtcvs.2009.04.028

Cited by 7 publications

(12 citation statements)

References 4 publications

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“…We have, nonetheless, encountered a channel arising from the lateral aspect of the ascending aorta in one of our patients with ventricular septal defect and pulmonary atresia in the setting of discordant ventriculoarterial connections (Fig 11). This channel, similar to the one described by Lee et al 16 and Subramanyan et al, 17 is directly comparable to the cartoon drawn by Gerlis et al, albeit with no interruption of the aorta.…”

Section: Double-barrelled Aortasupporting

confidence: 87%

“…This favours strongly its origin as a fifth arch artery. This channel is similar to the one described by Lee et al 16 and Subramanyan et al 17 Lcc = left common carotid; lsc = left subclavian.…”

Section: Double-barrelled Aortasupporting

confidence: 71%

“…Review of the current literature shows that a host of structures have been interpreted by paediatric cardiologists as representing persistent arteries of the fifth pharyngeal arch (Tables 1 and 2). 6,7,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Many of these entities produce the lesions known as the double-barrelled aortas. 6 Others produce various forms of systemic-to-pulmonary collateral channels.…”

mentioning

confidence: 99%

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How frequent is the fifth arch artery?

2014

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Although usually shown in embryology textbooks, the presence of the fifth pair of pharyngeal arch arteries has long been controversial. To the best of our knowledge, six pairs of bilaterally symmetrical arteries developing within the pharyngeal arches are yet to be found in any mammalian or avian species. Collateral channels between the distal ends of the fourth and sixth arch arteries, in contrast, have been found in up to half of all developing mouse embryos. In only one human embryo, again to the best of our knowledge, has a channel been found that extends from the aortic sac to the dorsal aorta, and hence qualifies as an arch artery. Despite these confounding factors in terms of the developmental heritage of the fifth arch arteries, the purported channels are invoked with increasing frequency to describe various lesions discovered in the setting of the congenitally malformed heart. Persistence of the artery of the fifth arch was initially proposed to explain double-barrelled aorta. It was subsequently proposed to account for various systemic-to-pulmonary channels feeding the pulmonary circulation in the setting of pulmonary atresia. It has also been claimed to persist so as to explain abnormal branching of the brachiocephalic arteries from the aortic arch. In the light of the ongoing doubts concerning the existence of the arteries of the fifth arch themselves, we have reviewed the various descriptions of purported fifth arch arteries within the world literature. We have then sought to validate the descriptions on the basis of our own understanding of development, for this purpose providing images of the remoulding arch arteries in the mouse so as to substantiate our conclusions. While accepting that our own interpretations are speculative, we suggest that more convincing alternative explanations can be advanced to account for the majority of lesions currently interpreted on the basis of persistence of the arteries of the fifth arches. Although the interpretations do not necessarily change the therapeutic approaches to the channels, appropriate description is important in terms of their classification.

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Section: Double-barrelled Aortasupporting

confidence: 87%

Section: Double-barrelled Aortasupporting

confidence: 71%

mentioning

confidence: 99%

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How frequent is the fifth arch artery?

2014

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“…Our four patients were given PGE1 routinely before and after surgery. 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.…”

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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“…Toute anomalie de développement embryologique de ces arcs aortiques serait à l' origine d'une série d'anomalies congénitales de l'aorte et de ses branches principales. La persistance du 5 ème arc aortique donne un gros canal artériel anormal reliant la partie distale de la crosse aortique soit à l'aorte descendante soit à l'artère pulmonaire [ 9 ]. D'après Van Praagh, il existe 3 types de 5 ème arc aortique persistant [ 6 ].…”

Section: Discussionunclassified

Persistance du 5ème arc aortique associé à une interruption de l’arche aortique

et al. 2017

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Les auteurs rapportent un cas de persistance du 5ème arc aortique associé à une interruption totale de l'arche aortique. Ce cas clinique montre le piège diagnostic posé par la persistance du 5ème arc aortique et son effet bénéfique hémodynamique. Le tableau clinique était trompeur en préopératoire en raison de la persistance des pouls fémoraux et des signes cliniques d'un shunt gauche-droite via un large canal artériel. Le diagnostic a été redressé en peropératoire grâce au monitorage de la pression artérielle par un cathéter placé dans l'artère fémorale.

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Persistent fifth aortic arch

Cited by 7 publications

References 4 publications

How frequent is the fifth arch artery?

How frequent is the fifth arch artery?

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

Persistance du 5ème arc aortique associé à une interruption de l’arche aortique

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