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[Cervical aortic arch associated with cardiopathy]
J M Sobrino Márquez1, I Gozalves, A Gómez
1Servicio de Hemodinámica, Hospital Infantil, Hospital Universitario Virgen del Rocío, Sevilla.
Insights
Cervical aortic arch is a rare anomaly found in infants with congenital heart defects like tetralogy of Fallot. Clinical presentation varies, and outcomes depend on associated cardiac malformations, not the arch anomaly itself.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Vascular Anomalies
Background:
- Cervical aortic arch is a rare congenital anomaly where the aortic arch arises from the descending aorta and courses superiorly.
- This anomaly is infrequently associated with complex congenital heart diseases.
Observation:
- This study reports on five pediatric patients diagnosed with cervical aortic arch.
- Associated cardiac conditions included tetralogy of Fallot (2), pulmonary atresia with interventricular septal defect (2), and pulmonary branch stenosis (1).
- Diagnosis occurred between one day and three months of age, with some cases identified via angiography before clinical signs manifested.
Findings:
- Two cases fit the Haughton classification, while three were unclassified.
- The clinical status of the affected children was primarily determined by the severity of their co-existing heart malformations.
- The cervical aortic arch itself did not appear to be the primary driver of immediate clinical condition.
Implications:
- Highlights the importance of comprehensive cardiac evaluation in infants with suspected or confirmed cervical aortic arch.
- Suggests that management strategies should focus on the associated intracardiac defects.
- Underscores the rarity and variable presentation of cervical aortic arch in pediatric populations.
Abstract:
We report five children affected with cervical aortic arch associated with tetralogy of Fallot (2), pulmonary atresia with interventricular septal defect (2) and pulmonary branch stenosis (1). Their ages were between one day and three months when they were diagnosed. With regard to one patient, the diagnosis was clinically suspected before catheterism. In four patients it was an angiographic finding since they didn't present the clinical signs when they underwent catheterism. One of these four patients showed such signs later. Only two cases can be inserted in Haughton classification; the other three can be included in the "unclassified group". Children's present clinical conditions are independent from this very rare anomaly and they depend on the associated heart malformations.