Secondary hypertension due to isolated interrupted aortic arch in a 45-year-old person

Zhou, Jian; Liu, Xin Wen; Yang, Yi; Wang, Bo Zhong; Wang, Jian An

doi:10.1097/md.0000000000009122

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…All the reported adult cases in literature belong to type A as in our case. 2,6 To the best of our knowledge, only seven cases of ruptured cerebral aneurysms with IAA are published in English literature till date, ours being the eighth one in the series (Table 1). 1,2,4,7–10 All these aneurysms, including our case, were saccular, and subarachnoid hemorrhage (SAH) was the presenting feature in all, except the one reported by Borcek et al, in which sentinel headache was present but CT head did not show SAH.…”

Section: Discussionmentioning

confidence: 92%

Ruptured cerebral aneurysm in isolated type A interrupted aortic arch managed by transradial endovascular route: A case report with literature review

et al. 2022

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Background and Introduction Interrupted aortic arch (IAA) is a very rare congenital anomaly carrying high neonatal mortality rate if left untreated. Rarer still, is its presentation in teenage or adulthood. This condition has been found to be complicated with cerebral aneurysms, which is a consequence of hemodynamic stress and hypertension secondary to arch interruption. Cerebral aneurysms can further complicate the clinical course and lead to poor clinical outcomes, especially if ruptured. Clinical Presentation A 17-year-old female presented with ruptured basilar top aneurysm and was considered for endovascular coiling. Transfemoral access was chosen but the catheter could not be negotiated beyond proximal thoracic aorta. A computed tomographic angiography (CTA) of thorax and abdomen was performed, which showed isolated interruption of aortic arch. Subsequently, transradial route was used for coiling of the aneurysm. Conclusion To the best of our knowledge, the index case is one of the only seven cases of IAA with cerebral aneurysm that have been reported till date in medical literature. It also holds the unique distinction of being the first case of IAA with cerebral aneurysm treated by endovascular approach. Our case highlights the importance of transradial access in such pathological conditions.

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Section: Discussionmentioning

confidence: 92%

Ruptured cerebral aneurysm in isolated type A interrupted aortic arch managed by transradial endovascular route: A case report with literature review

et al. 2022

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Assessment of intracardiac and extracardiac anomalies associated with coarctation of aorta and interrupted aortic arch using dual-source computed tomography

Zhao

Wang

Yang

et al. 2019

Sci Rep

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To evaluate the value of dual-source computed tomography (DSCT) compared with transthoracic echocardiography (TTE) in assessing intracardiac and extracardiac anomalies in patients with coarctation of aorta (CoA) and interrupted aortic arch (IAA). Seventy-five patients (63 with CoA and 12 with IAA) who received preoperative DSCT and TTE were retrospectively studied. Intracardiac and extracardiac anomalies were recorded and compared by DSCT and TTE, in reference to surgical or cardiac catheterization findings. A total of 155 associated anomalies were finally found. Collateral circulation (56, 74.70%), patent ductus arteriosus (PDA; 41, 54.67%) were the most common anomalies. PDA, aortopulmonary window, and collateral circulation were more frequently present in patients with IAA than those with CoA (100% vs. 46.03%, 16.67% vs. 0%, and 100% vs. 69.84%, respectively, all p < 0.05). DSCT was superior to TTE in assessing associated extracardiac-vascular anomalies (sensitivity: 100% vs. 39.81%; specificity: 100% vs. 100%; positive predictive value: 100% vs. 100%; negative predictive value: 100% vs. 76.06%). Extracardiac-vascular anomalies, including collateral circulation and PDA, were the most common anomalies in patients with IAA and CoA. Compared with TTE, DSCT is more reliable in providing an overall preoperative evaluation of morphological features and extracardiac anomalies for surgical planning.

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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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Secondary hypertension due to isolated interrupted aortic arch in a 45-year-old person

Cited by 4 publications

References 9 publications

Ruptured cerebral aneurysm in isolated type A interrupted aortic arch managed by transradial endovascular route: A case report with literature review

Ruptured cerebral aneurysm in isolated type A interrupted aortic arch managed by transradial endovascular route: A case report with literature review

Assessment of intracardiac and extracardiac anomalies associated with coarctation of aorta and interrupted aortic arch using dual-source computed tomography

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

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