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Bicarotid trunk: how much is "not uncommon"?

Lisa Reinshagen1, Janez Vodiskar1, Eberhard Mühler2

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The bicarotid trunk, a common aortic arch variation, occurs in 15.2% of pediatric patients with congenital heart defects. This anatomical finding is associated with aortic coarctation and requires careful surgical planning.

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Area of Science:

  • Cardiovascular anatomy and congenital heart disease research.
  • Pediatric cardiology and surgical risk assessment.

Background:

  • The bicarotid trunk is the most frequent aortic arch branching variation.
  • This anatomical variation can significantly impact surgical strategies for congenital heart defects.

Purpose of the Study:

  • To determine the prevalence of the bicarotid trunk in pediatric patients with congenital heart defects.
  • To investigate the association between the bicarotid trunk and aortic coarctation.

Main Methods:

  • Analysis of 2,033 pediatric cardiac catheterization reports from 1979-2010.
  • Evaluation of aortic arch branching patterns, prevalence of aortic coarctation, associated defects, vascular anomalies, and genetic syndromes.

Main Results:

  • A bicarotid trunk was present in 15.2% of the studied pediatric population.
  • Ventricular septal defects, valvular pulmonary stenosis, and atrial septal defect were common in patients with a bicarotid trunk.
  • Aberrant right subclavian artery and trisomy 21 were frequent associated findings.

Conclusions:

  • The bicarotid trunk is not rare, with a prevalence of 15.2% in this cohort and 17.6% in patients with aortic coarctation.
  • Clear depiction of aortic arch anatomy is crucial due to potential surgical risks associated with the bicarotid trunk.
  • Advanced imaging like MRI or angiography may be needed if ultrasonography is inconclusive.