• Journal of Cardiovascular Imaging
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• v.30 no.4
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• pp.231-262
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• 2022

There is a wide spectrum of congenital anomalies or variations of the aortic arch, ranging from non-symptomatic variations that are mostly detected incidentally to clinically symptomatic variations that cause severe respiratory distress or esophageal compression. Some of these may be accompanied by other congenital heart diseases or chromosomal anomalies. The widespread use of multidetector computed tomography (CT) in clinical practice has resulted in incidental detection of several variations of the aortic arch in adults. Thus, radiologists and clinicians should be aware of the classification of aortic arch anomalies and carefully look for imaging features associated with a high risk of clinical symptoms. Understanding the embryological development of the aortic arch aids in the classification of various subtypes of aortic arch anomalies and variants. For accurate diagnosis and precise evaluation of aortic arch anomalies, cross-sectional imaging modalities, such as multidetector CT or magnetic resonance imaging, play an important role by providing three-dimensional reconstructed images. In this review, we describe the embryological development of the thoracic aorta and discuss variations and anomalies of the aortic arch along with their clinical implications.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.659-672
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• 1987

Nitrofen [2,4-dichlorophenyl-P-nitrophenyl ether] is a diphenyl ether herbicide used for pre and post-emergent control of broad leafed weeds. This chemical was known to induce a variety of congenital cardiovascular anomalies with diaphragmatic hernia and hydronephrosis in the rate fetuses. The present study was conducted to produce congenital cardiovascular anomalies in the rat fetuses by oral nitrofen administration at the indicated doses and days of gestation, and to find the characteristics of nitrofen-induced cardiovascular anomalies. All the observed fetuses were removed from the pregnant Sprague-Dawley rats sacrificed on the twenty-first day of gestation. They were preserved in 10 per cent formalin and dissection for examination were carried out under a dissecting microscope using forceps and scissors. Following results and conclusion were based on dissecting microscopic findings on 482 offsprings. 1. The eleventh day of gestation was the most sensitive day for nitrofen induction of congenital cardiovascular anomalies in the rat. This incidence was dose-related in rats exposed on the eleventh day of gestation. 2. Ventricular septal defect was the most common single anomaly that represented more than half of the total cardiovascular anomalies, followed by aortic arch anomalies and tetralogy of Fallot. 3. Cardiac anomalies derived from infundibular maldevelopment such as tetralogy of Fallot and pulmonary atresia with ventricular septal defect were only observed in the eleventh gestation day treated group. 4. Aortic arch anomalies were found in high frequency and the great majority were characteristically anomalous right subclavian artery with left aortic arch. Key words; nitrofen, congenital cardiovascular anomalies.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.201-204
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• 1990

The double aortic arch is the commonest anomaly among the vascular rings are relatively rare congenital vascular anomalies. This anomaly is malformation of the aortic arch system may, by compression of the trachea and esophagus, cause respiratory distress and dysphagia. We experienced one case of double aortic arch with right sided descending aorta with predominant right anterior arch treated surgically at Kyung Hee University Medical Center. 1-year-old male patient with acute airway obstruction due to combination of double aortic arch and right descending aorta. The diagnosis was made by simple X-ray & confirmed by barium esophagogram & aortogram. The operative approach was through left thoracotomy & underwent division of the left aortic arch & division of ligamentum arteriosum & suspension of divided proximal end of anterior arch to anterior thoracic wall. The postoperative courses was uneventful and doing well on the 3 years.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.69-74
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• 2023

Subarachnoid hemorrhage (SAH) due to ruptured posterior cerebral artery (PCA) intracranial arterial dolichoectasia (IADE) is very rare. As these lesions are difficult to treat microsurgically, neurointervention is preferred because the dolichoectatic artery does not have a clear neck, and the surgical field of view was deep seated with the SAH. However, in some cases, neurointervention is difficult due to anatomical variation of the blood vessel to access the lesion. In this case, a 30-year-old male patient presented with a ruptured PCA IADE and an aortic arch anomaly. Aortic arch anomalies render it difficult to reach the ruptured PCA IADE via endovascular treatment. The orifice of the vertebral artery (VA) was different from the usual cases, so it was difficult to find the entrance. After only finding the VA and arriving at the lesion along the VA, trapping was performed. Herein, we report the PCA IADE with aortic arch anomaly endovascular treatment methods and results.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.206-211
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• 1991

Interruption of the aortic arch may be defined as discontinuity of the aortic arch in which either an aortic vessel or a patent ductus arteriosus supplies the descending aorta. This anomaly is a rare congenital malformation that usually occurs with severe associated intracardiac congenital anomalies, such as ventricular septal defect, patent foramen ovale and abnormal arrangement of the brachiocephalic arteries. Rarely, transposition of the great vessel, truncus arteriosus are coexistent. We experienced a case of the interrupted aortic arch [Type A] associated with VSD, PDA and patent foramen ovale in a 16 years old female. One stage total correction was done under profound hypothermia with total circulatory arrest. Aortic continuity was established using patent ductus arteriosus with anterior wall of main pulmonary artery, which was anastomosed obliquely to anteromedial side of the ascending aorta. Ventricular septal defect was closed using Dacron patch and patent foramen ovale was closed directly. Postoperative course was uneventful, except mild hoarseness.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.286-290
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• 2023

Various branch anomalies of the aortic arch have been reported, but cases with separate origins of the internal and external carotid arteries with combined direct aortic arch origin of the left vertebral artery are extremely rare. Herein, we present a rare case of aplasia of the left common carotid artery with separate origins of the ipsilateral internal and external carotid arteries and vertebral artery from the aortic arch in a 10-year-old girl. In addition, we review the embryological development and clinical implications of these anatomical variations.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.39-41
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• 2016

Persistent fifth aortic arch (PFAA) is a rare congenital anomaly of the aortic arch frequently associated with other cardiovascular anomalies, such as tetralogy of Fallot and aortic arch coarctation or interruption. We report the case of a neonate with PFAA with coarctation who successfully underwent surgical repair.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.665-671
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• 1988

Between 1981 and 1987, five patients with an interruption of the aortic arch were operated upon. All had a ventricular septal defect and a patent ductus arteriosus as associated anomalies. A two-stage procedure was employed in these cases, the initial procedure being repair of the interrupted arch, ligation of the patent ductus arteriosus, banding of the main pulmonary artery and a lung biopsy which was followed, 5 to 49 months later, by the repair of the ventricular septal defect. Four patients completed the two-stage procedure with one postoperative mortality. The remaining patient is yet to complete the second stage procedure.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.159-163
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• 1995

Double aortic arch is the most common among vascular structure anomalies in infancy. It's clinical manifestations vary from incidental discovery without symptoms to symptoms of tracheal or esophageal compression such as stridor, wheezing, excessive secretion, dyspnea and dysphagia. Characteristically many patients show little sign of respiratory difficulty during sleep and quiet monents but this symptom is frequently exacerbated by crying or exertion, which may be difficult to distinguish from bronchial asthma. CT and MRI are believed to be the most valuable methods of diagnosis and surgical intervention is necessary in severe cases. Recently, we experienced a case of dyspnea due to double aortic arch. So we report this case with review of literatures.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.205-211
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• 1984

Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. We have presented six patients with surgically treated vascular rings at Seoul National University Hospital during the period June 1970 through May 1984. Two patients had double aortic arches and four patients had right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Four patients had symptoms relating vascular ring and two patients were detected incidentally during diagnostic evaluation of symptomatic intracardiac defects. Associated congenital malformations were seen in four patients. The operative approach was through left thoracotomy in three patients and median sternotomy in remaining three patients associated with congenital cardiac defects. There were no postoperative deaths with excellent result in preoperative symptomatic patients. To our knowledge, successful surgical repair of vascular ring has been reported only once in the Korean literature.