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Anomalous subaortic course of brachiocephalic vein: Evaluation on multidetector computed tomography angiography

Mansi Verma1, Niraj Nirmal Pandey1, Sivasubramanian Ramakrishnan2

  • 1Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.

Journal of Cardiac Surgery
|October 12, 2021
PubMed

Insights

An anomalous subaortic brachiocephalic vein is found in 2.9% of patients with congenital heart disease, frequently associated with tetralogy of Fallot. Identifying this anomaly is crucial for surgical planning and avoiding complications.

Area of Science:

  • Cardiovascular Imaging
  • Congenital Heart Disease
  • Vascular Anatomy

Background:

  • Anomalous venous development can impact cardiovascular health.
  • Subaortic brachiocephalic vein is a rare anomaly.
  • Multidetector computed tomography (CT) angiography is key for diagnosis.

Purpose of the Study:

  • To evaluate the morphology of subaortic brachiocephalic vein.
  • To identify associated cardiovascular abnormalities.
  • To assess the prevalence of this anomaly in congenital heart disease patients.

Main Methods:

  • Retrospective study of 4349 patients undergoing MDCT angiography.
  • Identification of subaortic brachiocephalic vein between January 2014 and July 2021.
  • Detailed evaluation of venous morphology and cardiovascular anatomy.

Main Results:

  • 126 patients (2.9%) had subaortic brachiocephalic vein.
  • Common associations: Tetralogy of Fallot (88.1%), right aortic arch (62%), and right ventricular outflow obstruction (94.4%).
  • Pulmonary stenosis or atresia were frequent findings.

Conclusions:

  • Subaortic brachiocephalic vein frequently coexists with complex congenital heart diseases.
  • Association with Tetralogy of Fallot, right aortic arch, and pulmonary stenosis/atresia is common.
  • Pre-procedural identification is vital to prevent surgical or catheterization complications.
Abstract

Keywords:
multidetector computed tomography angiographysubaortic course of brachiocephalic veintetralogy of Fallot

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