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Aortic arch interruption in infancy: radio- and angiographic features
Insights
Interrupted aortic arch in infants is often associated with other heart defects. Left ventriculography is key for diagnosis, supporting theories on fetal blood flow affecting aortic arch development.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Medical Imaging
Background:
- Interrupted aortic arch (IAA) is a rare congenital heart defect.
- It requires prompt diagnosis and management in neonates.
- Understanding associated anomalies is crucial for surgical planning.
Purpose of the Study:
- To review the radio- and angiocardiographic features of infants with interrupted aortic arch.
- To identify common associated cardiovascular anomalies.
- To evaluate the diagnostic utility of imaging modalities.
Main Methods:
- Retrospective review of 19 infants diagnosed with interrupted aortic arch.
- Analysis of radiographic and angiocardiographic findings.
- Correlation of imaging findings with clinical data.
Main Results:
- Fifteen infants had Type B IAA (between left carotid and subclavian arteries).
- Ventricular septal defect (19/19) and patent ductus arteriosus (18/19) were most common.
- Left ventriculography was diagnostic for IAA and other abnormalities.
Conclusions:
- Plain film findings for IAA are nonspecific.
- Left ventriculography is essential for diagnosing IAA and associated defects.
- Findings support the theory linking decreased fetal ascending aorta flow to IAA development.
Abstract:
The radio- and angiocardiographic characteristics of 19 infants with an interrupted aortic arch were reviewed. There were three with type A (distal to the left subclavian artery), 15 with type B (between the left carotid and subclavian arteries), and one with type C (between the innominate and left carotid arteries). Associated cardiovascular anomalies were numerous, a ventricular septal defect (19/19) and a patent ductus arterisous (18/19) being the most common. Plain film signs of aortic interruption were nonspecific. Left ventriculography using angled oblique views was diagnostic of the interruption and most other abnormalities. The constant presence of a ventricular septal defect and frequent occurrence of left ventricular outflow obstruction in these infants lends support to the theory that decreased flow in the fetal ascending aorta predisposes to interruption of the aortic arch.