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Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations

  • Doff B. McElhinney (a1), Norman H. Silverman (a2), Michael M. Brook (a2), V. Mohan Reddy (a1) and Frank L. Hanley (a1)...

Abstract

Isolation of the subclavian artery is an unusual anomaly in which the subclavian artery arises not from the aortic arch but from a pulmonary artery via an arterial duct. Such isolation most often occurs with a right aortic arch, and in lesions frequently associated with a right arc, such as tetralogy of Fallot. Since1994, we have undertaken surgery in four young infants with isolated subclavian arteries and unusual associated anomalies, including one with atrioventricular septal defect and common valvar orifice, two with interruption of a left aortic arch and one with interruption of a right aortic arch. In both patients with interrupted left arch, the isolated subclavian artery was diagnosed preperatively by echocardiography. We emphasize the significant issues.

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Corresponding author

Doff B. McElhinney, MS

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1.Nath, PH, Castaneda, Zuniga W, Zollikofer, C, Delany, DJ, Fulton, RE, Amplatz, K, Edwards, JE. Isolation of a subclavian artery. Am J Roentgenol 1981; 137: 683688.
2.Victoria, BE, Van Mierop, LHS, Elliott, LP. Right aortic arch associated with contralateral congenital subclavian steal syndrome.Am J Roentgenol 1970; 108:582590
3.Luetmer, PH, Miller, GM. Right aortic arch with isolation of the left subclavian artery: case report and review of the literature. Mayo Clin Proc 1990;65:407413.
4.Bharati, S, Lev, M. The pathology of congential heart disease: Apersonal experience with more than 6,300 congenitally malformed hearts. Futura, New York, 1996, pp. 67133, 553–586.
5.Mishaly, D, Birk, E, Katz, J, Vidne, BA. Interruption of right sided aortic arch: case report and review of the literature. J Cardiovasc Surg 1995; 36: 277279.
6.Papagiannis, J, Kanter, RJ, Vander Heide, RS, Reimer, KA, Ungerleider, RM, Van, Praagh R. Isolated innominate artery in asplenia syndrome with aortic atresia: newly recognized cardiovascular complex. Am Heart J 1996; 131:10421044.
7.Van Mierop, LHS, Kutsche, LM. Interruption of the aortic arch and coarctation of the aorta: pathogenetic relations. Am J Cardiol 1984; 829834.
8.Moller, JH, Edwards, JE. Interruption of aortic arch: anatomic patterns and associated cardiac malformations. Am J Radiol 1965; 95: 557572.
9.Mulay, AV, Watterson, KG. Isolated right subclavian artery, interrupted aortic arch, and ventricular septal defect. Ann Thorac surg 1997; 63 11631165.
10.Van Praagh, R, Bernhard, WF, Rosenthal, A, Parisi, LF, Fyler, DC. Interrupted aortic arch: Surgical treatment. Am J Cardiol 1971; 27:200211.
11.Celoria, GC, Patton, RB. Congenital absence of the aortic arch. Am Heart J 1959;407413.
12.Kleinerman, J, Yang, WM, Hackel, DB, Kaufman, N. Absence of the transverse aortic arch. Arch Path 1958; 65: 490498.
13.Pierpont, MEM, Zollikofer, CL, Moller, JH, Edwards, JE. Interruption of the aortic arch with right descending aorta: A rare condition and a cause of bronchial compression. Pediatr Cardiol 1982;2: 153159.
14.Deeg, KH, Hofbeck, M, Singer, H. Diagnosis of subclavian steal in infants with coarctation of the aorta and interruption of the aortic arch by color-coded Doppler sonography.J Ultrasound Med 1993;12:713718.
15.Edwards, JE. Annomalies of the derivatives of the aortic arch system. Med Clin North Am 1948; 32:925949
16.Van Mierop, LHS, Kutsche, LM. cardiovascular anomalies in DiGeeorge syndrome and importance of neural crest as a possible pathogenetic factor. Am J Cardiol 1986; 58:133137.
17.Revich, M, Holling, HE, Roberts, B, Toole, JF. Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 1961;265:878885.
18.Gonzales, L, Weintraub, RA, Wiot, JF. Retrograde vertebral artery blood flow: a normal phenomenon. Radiology 1964;82: 211216.
19.Lodge, FA, Lamberti, JJ, Goodman, AH, Kirpatrick, SE, George, L, Mathewson, JL, Waldman, JD. Vascular consequences of subclavian artery transection for the treatment of congential disease. J Thorac Cardiovasc Surg. 1983;86:1823.
20.Folger, GM, Shah, KD. Subclavian steal in patients with Blalock-Taussig anastomosis. Circulation 1965;31:241248.
21.Marshall, RJ, Mantini, EL. Dynamics of the collateral circulation in patiens with subclavian steal. Circulation 1965;31:249254.
22.Nair, SK, Subramanyam, R, Venkiachalam, CG, Valiathan, MS. Right aortic arch with isolation of the left subclavian artery and bilateral patent ductus arterioses. J Cardiovasc Surg 1992;33:242244.

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Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations

  • Doff B. McElhinney (a1), Norman H. Silverman (a2), Michael M. Brook (a2), V. Mohan Reddy (a1) and Frank L. Hanley (a1)...

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