Coarctation of persistent 5th aortic arch: first report of catheter-based intervention

Area of Science:

• Cardiovascular Medicine
• Pediatric Cardiology
• Medical Imaging

Background:

• Persistent 5th aortic arch (P5AA), historically termed double-lumen aortic arch, is a rare congenital heart anomaly.
• P5AA typically leads to abnormal systemic-to-systemic or systemic-to-pulmonary shunting.
• Intracardiac defects frequently accompany P5AA, making isolated presentations uncommon.

Observation:

• A 7-month-old female infant presented with an audible heart murmur.
• Diagnostic workup revealed an interrupted 4th aortic arch and coarctation of a P5AA.
• Notably, no other intracardiac defects were identified in this patient.

Findings:

• This case represents the third reported instance of an isolated P5AA in a pediatric patient.
• The diagnosis was confirmed, and the condition was successfully managed using cardiac catheterization and balloon angioplasty.
• This marks the first documented case of diagnosing and treating isolated P5AA with these interventional techniques.

Implications:

• The findings highlight the possibility of isolated P5AA, challenging previous assumptions of frequent co-occurrence with other defects.
• Cardiac catheterization and balloon angioplasty demonstrate a viable, minimally invasive treatment option for this rare anomaly.
• This case expands the understanding of P5AA management and offers a potential therapeutic pathway for affected pediatric patients.