Collateral dependent cerebral and coronary circulation in a newborn

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Interrupted aortic arch (IAA) and aortic atresia are severe congenital heart defects.
• Hypoplastic left heart syndrome (HLHS) encompasses a spectrum of left-sided heart underdevelopment.
• The combination of IAA with aortic atresia as an HLHS variant is exceptionally rare and typically not survivable.

Purpose of the Study:

• To report an extremely rare case of interrupted aortic arch with aortic atresia, considered a variant of hypoplastic left heart syndrome.
• To highlight the critical role of collateral circulation in sustaining life with complex congenital heart defects.

Main Methods:

• Case report presentation.
• Review of relevant medical literature.

Main Results:

• The patient presented with a rare variant of HLHS, combining interrupted aortic arch and aortic atresia.
• A significant collateral artery was identified, bridging the descending aorta and the right subclavian artery.
• This collateral pathway was crucial for providing necessary cerebral and coronary blood flow.

Conclusions:

• This case underscores the potential for survival in seemingly non-compatible congenital heart defects through anomalous vascular pathways.
• The presence of a large collateral artery can be life-sustaining in complex cardiac anomalies like IAA with aortic atresia.
• Further research into collateral circulation mechanisms in congenital heart disease is warranted.