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Persistent cervical intersegmental artery and aortic arch coarctation.

V Gluncić1, I K Lukić, M Kopljar

  • 1Department of Anatomy, Zagreb University School of Medicine, Croatia.

Surgical and Radiologic Anatomy : SRA
|October 11, 2002
PubMed
Summary

A rare congenital anomaly involving aortic coarctation and an anomalous cervical artery was identified. This unique vascular formation significantly altered blood flow, impacting myocardial afterload.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Medical Imaging

Background:

  • Aortic coarctation is a congenital narrowing of the aorta, often presenting with hypertension.
  • Continuous precordial murmurs can indicate turbulent blood flow, suggestive of structural heart or great vessel abnormalities.

Observation:

  • A 15-year-old female presented with upper extremity hypertension and a continuous precordial murmur.
  • Arteriography revealed aortic coarctation proximal to the left subclavian artery origin.
  • An anomalous artery originated from the aortic arch, supplying an angiomatous vascular formation in the neck that drained into the left subclavian artery.

Findings:

  • The embryological origin is likely related to persistent cervical intersegmental arteries due to hemodynamic changes from pre-stenotic hypertension.

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  • The angiomatous formation may result from altered development of anastomoses between vertebral and deep cervical arteries.
  • Aberrant collateral flow was hemodynamically significant, reducing myocardial afterload without significant left ventricular hypertrophy.

    • Implications:

    • This case highlights an extremely rare collateral circulation pattern in aortic coarctation.
    • Understanding such anomalies is crucial for accurate preoperative planning in pediatric cardiovascular surgery.
    • Interpretation of imaging studies requires awareness of these unusual vascular variations to avoid misdiagnosis.