Abstract
Objective . To demonstrate the pitfalls of echocardiography in detection of rare congenital anomalies of the aortic arch and brachiocephalic
vessels taking into account the implementation of an adequate surgical intervention.
Material and methods . We analyzed the echo-data of 21 patients. Age ranged from 3 days to 1 years and 6 months. The ratio of male
and female was 8:13. Echocardiographic examination was performed in all patients. Multidetector computed tomography of the heart
and thoracic aorta was performed in 19 infants, angiocardiography in 2 patients.
Results . Multimodality diagnostics allowed to completely assessment the anatomy of the rare anomalies of the aortic arch and brachiocephalic
vessels. Analysis of data obtained through various methods of visualization have shown the limitation of the echocardiography
in diagnosis the anomalies of extra cardiac structures: in 10 cases computed tomography or angiocardiography added
new details of the anatomy of congenital anomalies of the aortic arch and brachiocephalic vessels, what influenced the choice of surgical
treatment. In 2 cases the final diagnosis of the anatomy of the defect was in the operating room.
Conclusion . Echocardiography is the primary diagnostic tool in assessment of a rare anomaly of the aortic arch and brachiocephalic
vessels and determines further examination and treatment of the patient. Echocardiography does not allow to obtain full information
about non cardiac structures, that's why the preoperative diagnostic algorithm required to complete multidetector computed
tomography or angiocardiography.
References
- Флакскампф Ф.А. (ред.) Практическая эхокардиография:
руководство по эхокардиографической диагностике.
М.: МЕДпресс-информ; 2013.
- Satti S.R., Cerniglia C.A., Koenigsberg R.A. Cervical vertebral
artery variations: an anatomic study. Am. J. Neuroradiol.
2007; 28 (5): 976–80.
- Бураковский В.И., Бокерия Л.А. (ред.) Сердечно-сосудис-
тая хирургия: Руководство. М.: Медицина; 1996.
- Brockes C., Vogt P.R., Rothe T.B., Arbenz U., Turina J. Double
aortic arch: clinical aspects, diagnosis and therapy in children
and adults. Z. Kardiol. 2001; 90 (2): 127–32.
- Ruzmetov M., Vijay P., Rodefeld M.D., Turrentine M.W.,
Brown J.W. Follow-up of surgical correction of aortic arch
anomalies causing tracheoesophageal compression: a 38-year
single institution experience. J. Pediatr. Surg. 2009; 44 (7):
1328–32.
- Woods R.K., Sharp R.J., Holcomb G.W., Snyder C.L., Lofland
G.K., Ashcraft K.W., Holder T.M. Vascular anomalies and
tracheoesophageal compression: a single institution's 25-year
experience. Ann. Thorac. Surg. 2001.; 72 (2): 434–8; discussion
438–9.
- Lee Y., Hong S.W. Abnormal origin of the left subclavian artery
from the left pulmonary artery in a patient with double outlet
right ventricle. Korean J. Thorac. Cardiovasc. Surg. 2014;
47 (1): 32–4.
- Vuran C., Omay O., Ayabakan C., Kocyigit O.I., Yoruker U.,
Turkoz R. A rare anatomic variation: a combination of anomalous
origin of the right subclavian artery from the mainpulmonary
artery, ventricular septal defect, and aortic coarctation.
Heart Surg. Forum. 2010; 13 (3): E202–4.
- Иващенко Д.К., Бокерия Л.А., Свободов А.А., Соболев А.В., Саркисян А.В., Амброладзе Ш.Р., Баринштейн Д.Б. Случай успешной коррекции аномального отхождения левой подключичной артерии от легочной артерии в сочетании с дефектом аортолегочной перегородки и
дефектом межжелудочковой перегородки у ребенка 9,5 месяцев. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2012;
13 (s6, приложение): 273.
- Гидаспов Н.А. Тактика и непосредственные результаты хирургического лечения пациентов с аномалиями дуги аорты
при их сочетании с другими заболеваниями грудной аорты
и ее ветвей: Дис. … канд. мед. наук; 2009.
- Chen X., Qu Y.J., Peng Z.Y., Lu J.G., Ma X.J. Diagnosis of congenital
aortic arch anomalies in chinese children by multidetector
computed tomography angiography. J. Huazhong
Univ. Sci. Technolog. Med. Sci. 2013; 33 (3): 447–51.
