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Published on: March 26, 2018

Cervical origin of the right subclavian artery in aortic arch interruption: pathogenesis and significance

L M Kutsche, L H Van Mierop

    The American Journal of Cardiology
    |March 15, 1984
    PubMed

    Insights

    Anomalous origin of the right subclavian artery (SA) is common in infants with type B aortic arch interruption. This developmental anomaly may result from early disappearance of the fourth aortic arches during embryonic development.

    Area of Science:

    • Embryology
    • Cardiovascular Anatomy
    • Developmental Biology

    Background:

    • Aortic arch interruption, specifically type B, presents unique anatomical challenges.
    • The origin of the right subclavian artery (SA) can be variable in congenital heart defects.

    Purpose of the Study:

    • To investigate the incidence and patterns of anomalous right subclavian artery (SA) origin in infants with type B aortic arch interruption.
    • To explore the potential embryological mechanisms underlying these anomalies.

    Main Methods:

    • Retrospective analysis of 21 infant hearts with type B aortic arch interruption.
    • Detailed anatomical description of the origin and course of the right subclavian artery.

    Main Results:

    • 66% of cases (14/21) exhibited anomalous right SA origin.
    • Common anomalies included origin from the descending aorta (43%) or right pulmonary artery (5%).
    • A previously unreported trifurcation anomaly of the right SA with carotid arteries occurred in 19% (4/21).

    Conclusions:

    • Anomalous right SA origin is a frequent finding in type B aortic arch interruption.
    • Early involution of the fourth aortic arches is implicated as the developmental cause.
    • The findings highlight the complex vascular patterning during embryonic development.

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