Unexpected Diagnosis and Management of a Type A Interrupted Aortic Arch in an Adult Male Scheduled for Mitral Valve Surgery

Casati, Valter; Barbato, Luciano; Spagnolo, Pietro; Kalandadze, Paata; Arone, Vincenzo; Grasso, Antonietta; Khouri, Toufic; Spagnolo, Salvatore

doi:10.1053/j.jvca.2007.03.013

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…Our group recently published a similar case 2 that nevertheless was not quoted in the literature found by Gordon et al regarding IAA diagnosed in the adult.…”

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confidence: 59%

Interrupted Aortic Arch in the Adult

Casati

Novelli

2011

Journal of Cardiac Surgery

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“…Our group recently published a similar case 2 that nevertheless was not quoted in the literature found by Gordon et al regarding IAA diagnosed in the adult.…”

supporting

confidence: 59%

Interrupted Aortic Arch in the Adult

Casati

Novelli

2011

Journal of Cardiac Surgery

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“…9,11,14 Although most of the authors suggest the extra-anatomical approach via median sternotomy, we repaired the IAA through a left thoracotomy. We were led to this approach due to the refusal of the patient to repair in 1-stage the IAA and the ascending aorta aneurysm, and to avoid adhesions under the sternum that could compromise the efforts of repairing the ascending aortic aneurysm in the second operation in the future.…”

Section: Discussionmentioning

confidence: 99%

Latent Congenital Defect: Interrupted Aortic Arch in an Adult—Case Report and Literature Review

Sakellaridis

Argiriou

Panagiotakopoulos

et al. 2010

Vasc Endovascular Surg

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Interrupted aortic arch (IAA) is rare congenital cardiac defect defined as a complete loss of luminal and anatomical continuity between ascending and descending segments of the aorta. Usually it is detected in the perinatal period or during the first hours or days of infancy. If not treated surgically, it usually is lethal. Nevertheless, diagnosis can be made in adults but is a very rare entity. Extremely few cases in adults are reported in the pertinent medical literature. We present an asymptomatic 62-year-old patient who was found to have IAA after examination for hypertension. The patient underwent a successful anatomical repair, with an uneventful postoperative course, and follow-up examinations reveal regression of hypertension and excellent health condition.

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“…Krishna SC et al [10] 23/M A 20 mm 17 Celkan MA et al [21] 35/M A Size not stated 18 Casati V et al [22] 35/M A 16 mm tomography unit are a reliable noninvasive diagnostic modality for the precise diagnosis of aortic coarctation and aortic arch anomalies. In addition, as in our case, they are useful for the visualization of the collateral vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Most adult patients with IAA have been repaired by using a single-stage extra-anatomic approach (Table 1). [10][11][12][13][14][15][16][17][18][19][20][21][22] For our case, the correction was done in a single setting by using an extra-anatomic bypass with a tubular Dacron graft. Different sizes (10-20 mm) of extra-anatomic Dacron tubular grafts have been used in the literature for this procedure, but we preferred a 22 mm Dacron graft, the largest graft we saw in the literature, in an effort to obtain a better distal blood flow.…”

Section: Discussionmentioning

confidence: 99%

The single-stage extra-anatomic repair of an isolated interrupted aortic arch in an adult and a review of the literature

Özeren¹

2012

Turk Gogus Kalp Dama

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Kesintiye uğramış arkus aort, çıkan ve inen aort arasında lümenin tamamen kaybı ve anatomik sürekliliğin olmaması ile karakterize, nadir ve ciddi bir doğuştan kalp defektidir. Bu malformasyonun prognozu, cerrahi olarak tedavi edilmez ise kötüdür. Bu yazıda tip A kesintiye uğramış arkus aortu olan ve cerrahi ile başarılı bir şekilde tedavi edilen 56 yaşında erkek hasta, konu ile ilgili literatür göz-den geçirilerek sunuldu.Anah tar söz cük ler: Erişkin; doğuştan; ekstra anatomik baypas; kesintiye uğramış arkus aort.Interrupted aortic arch is a rare and severe congenital heart defect characterized by a complete loss of luminal and anatomic continuity between the ascending and the descending aorta. This malformation has a poor prognosis without surgical treatment. In this article, we present a 56-year-old male patient with interrupted aortic arch type A who was treated successfully with surgery, and review the literature regarding this topic.Key words: Adult; congenital; extra-anatomic bypass; interrupted aortic arch.The interruption of the aortic arch (IAA) characterized by complete luminal and anatomic discontinuity between the ascending and descending aorta is an extremely rare entity in the adult population.[1] It is often diagnosed and repaired during the neonatal period. The prognosis for this anomaly depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. We found 18 adult cases (18 years and older) of IAA which had been surgically treated by extra-anatomic bypass in the literature. Herein we describe a successful extra-anatomic repair in a patient who had an isolated type A aortic interruption. CASE REPORTA 56-year-old male patient arrived at the cardiology clinic of our hospital complaining of chest pain and shortness of breath. He also had a history of stroke due to an intracranial hemorrhage and hypertension, which had been treated with angiotensin-converting enzyme (ACE) inhibitors. On his physical examination, the peripheral pulses were normally palpable in the upper extremities, but they were reduced in the lower limbs. Cardiac auscultation revealed a rhythmic tachycardia with no additional heart sounds. Electrocardiography showed sinus tachycardia and signs of left ventricular hypertrophy and ST-T wave changes. Chest radiography showed an increased cardiothoracic ratio. Laboratory results were within normal ranges.An angiography was performed via the femoral approach for coronary artery imaging, but the catheter could not be inserted to the arcus aorta (Figure 1a). Interruption of the thoracic aorta was suspected. The angiography was then repeated via the brachial approach, and the interruption of the arcus aorta was diagnosed with normal coronary arteries (Figure 1b). An angiotomography of the aorta was then requested which disclosed an aortic occlusion 2 cm after the origin of the left subclavian artery (Figure 2a). This

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Unexpected Diagnosis and Management of a Type A Interrupted Aortic Arch in an Adult Male Scheduled for Mitral Valve Surgery

Cited by 7 publications

References 15 publications

Interrupted Aortic Arch in the Adult

Interrupted Aortic Arch in the Adult

Latent Congenital Defect: Interrupted Aortic Arch in an Adult—Case Report and Literature Review

The single-stage extra-anatomic repair of an isolated interrupted aortic arch in an adult and a review of the literature

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