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Distal aortic arch aneurysm associated with persistent fifth aortic arch.
Takahiro Inoue1, Kiyozo Morita, Kei Tanaka
1Department of Cardiac Surgery, The Jikei University, Minato-ku, Tokyo, Japan.
Summary
Persistent fifth aortic arch (PFAA) is a rare condition. This case highlights a distal aortic arch aneurysm in an adult, emphasizing the need for accurate diagnosis and understanding of PFAA for effective surgical management.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Vascular Malformations
Background:
- Persistent fifth aortic arch (PFAA) is a rare congenital anomaly.
- PFAA is often associated with interruption of the fourth aortic arch.
- Surgical intervention is typically required in childhood.
Observation:
- A 51-year-old woman presented with a distal aortic arch aneurysm.
- The aneurysm developed after childhood patch aortoplasty for coarctation of the aorta.
- This is the first reported case of a distal aortic arch aneurysm associated with PFAA.
Findings:
- The aneurysm's development may be linked to residual ductus arteriosus and PFAA tissues, along with the synthetic patch used in prior surgery.
- Surgical repair involved graft interposition due to severe adhesions preventing use of the fourth aortic arch.
Implications:
- Accurate diagnosis of PFAA is crucial for appropriate surgical planning.
- Understanding PFAA allows for timely intervention in childhood, potentially leading to better long-term outcomes.
- This case expands the understanding of potential late complications associated with PFAA and aortic arch anomalies.
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