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Aortic arch advancement for type A interrupted aortic arch with persistent fifth aortic arch type B
Ziyad M Binsalamah1, Peter Chen1, Emmett D McKenzie1
1Michael E. DeBakey Department of Surgery,Division of Congenital Heart Surgery,Baylor College of Medicine,Houston,Texas,United States of America.
Cardiology in the Young
|March 7, 2017
Summary
Persistence of the fifth aortic arch, a rare anomaly, can be clinically significant when it co-occurs with coarctation. This case highlights a neonate with interrupted aortic arch and coarctation involving a persistent fifth aortic arch.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- The fifth aortic arch is typically a transient structure during embryonic development.
- Persistence of the fifth aortic arch is an exceedingly rare congenital anomaly.
- Its association with coarctation of the aorta presents unique surgical challenges.
Observation:
- A neonate presented with a complex congenital anomaly post-left congenital diaphragmatic hernia repair.
- Intraoperative findings revealed a type A interrupted aortic arch and severe coarctation.
- A persistent fifth aortic arch was identified as contributing to the aortic arch malformation.
Findings:
- The neonate had a rare combination of interrupted aortic arch, severe coarctation, and a persistent fifth aortic arch.
- Surgical intervention involved aortic arch advancement to address the complex anatomy.
- The patient experienced an uncomplicated postoperative recovery.
Implications:
- This case underscores the importance of recognizing rare aortic arch anomalies in neonates.
- Early diagnosis and appropriate surgical management are crucial for favorable outcomes.
- Understanding persistent fifth aortic arch variations can improve surgical planning for complex congenital heart defects.
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