Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T00:13:09.283Z Has data issue: false hasContentIssue false
  • English
  • Français

Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations

Published online by Cambridge University Press:  19 August 2008

Doff B. McElhinney ,
Norman H. Silverman ,
Michael M. Brook ,
V. Mohan Reddy  and
Frank L. Hanley
Doff B. McElhinney*
Affiliation:
Divisions of Cardiothoracic Surgery, University of California, San Francisco, San Francisco, CA, USA
Norman H. Silverman
Affiliation:
Pediatric Cardiology, University of California, San Francisco, San Francisco, CA, USA
Michael M. Brook
Affiliation:
Pediatric Cardiology, University of California, San Francisco, San Francisco, CA, USA
V. Mohan Reddy
Affiliation:
Divisions of Cardiothoracic Surgery, University of California, San Francisco, San Francisco, CA, USA
Frank L. Hanley
Affiliation:
Divisions of Cardiothoracic Surgery, University of California, San Francisco, San Francisco, CA, USA
*
Doff B. McElhinney, MS
Get access Rights & Permissions [Opens in a new window]

Abstract

Isolation of the subclavian artery is an unusual anomaly in which the subclavian artery arises not from the aortic arch but from a pulmonary artery via an arterial duct. Such isolation most often occurs with a right aortic arch, and in lesions frequently associated with a right arc, such as tetralogy of Fallot. Since1994, we have undertaken surgery in four young infants with isolated subclavian arteries and unusual associated anomalies, including one with atrioventricular septal defect and common valvar orifice, two with interruption of a left aortic arch and one with interruption of a right aortic arch. In both patients with interrupted left arch, the isolated subclavian artery was diagnosed preperatively by echocardiography. We emphasize the significant issues.

Keywords

Aortic arch anomaliessubclavian stealinterrupted aortic archanomalous subclavian artery
Type
Original Articles
Information
Cardiology in the Young , Volume 8 , Issue 3 , July 1998 , pp. 344 - 351
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Nath, PH, Castaneda, Zuniga W, Zollikofer, C, Delany, DJ, Fulton, RE, Amplatz, K, Edwards, JE. Isolation of a subclavian artery. Am J Roentgenol 1981; 137: 683–688.CrossRefGoogle ScholarPubMed
2.Victoria, BE, Van Mierop, LHS, Elliott, LP. Right aortic arch associated with contralateral congenital subclavian steal syndrome.Am J Roentgenol 1970; 108:582–590CrossRefGoogle Scholar
3.Luetmer, PH, Miller, GM. Right aortic arch with isolation of the left subclavian artery: case report and review of the literature. Mayo Clin Proc 1990;65:407–413.Google Scholar
4.Bharati, S, Lev, M. The pathology of congential heart disease: Apersonal experience with more than 6,300 congenitally malformed hearts. Futura, New York, 1996, pp. 67–133, 553–586.Google Scholar
5.Mishaly, D, Birk, E, Katz, J, Vidne, BA. Interruption of right sided aortic arch: case report and review of the literature. J Cardiovasc Surg 1995; 36: 277–279.Google ScholarPubMed
6.Papagiannis, J, Kanter, RJ, Vander Heide, RS, Reimer, KA, Ungerleider, RM, Van, Praagh R. Isolated innominate artery in asplenia syndrome with aortic atresia: newly recognized cardiovascular complex. Am Heart J 1996; 131:1042–1044.Google Scholar
7.Van Mierop, LHS, Kutsche, LM. Interruption of the aortic arch and coarctation of the aorta: pathogenetic relations. Am J Cardiol 1984; 829–834.CrossRefGoogle ScholarPubMed
8.Moller, JH, Edwards, JE. Interruption of aortic arch: anatomic patterns and associated cardiac malformations. Am J Radiol 1965; 95: 557–572.Google Scholar
9.Mulay, AV, Watterson, KG. Isolated right subclavian artery, interrupted aortic arch, and ventricular septal defect. Ann Thorac surg 1997; 63 1163–1165.CrossRefGoogle ScholarPubMed
10.Van Praagh, R, Bernhard, WF, Rosenthal, A, Parisi, LF, Fyler, DC. Interrupted aortic arch: Surgical treatment. Am J Cardiol 1971; 27:200–211.CrossRefGoogle ScholarPubMed
11.Celoria, GC, Patton, RB. Congenital absence of the aortic arch. Am Heart J 1959;407–413.CrossRefGoogle ScholarPubMed
12.Kleinerman, J, Yang, WM, Hackel, DB, Kaufman, N. Absence of the transverse aortic arch. Arch Path 1958; 65: 490–498.Google Scholar
13.Pierpont, MEM, Zollikofer, CL, Moller, JH, Edwards, JE. Interruption of the aortic arch with right descending aorta: A rare condition and a cause of bronchial compression. Pediatr Cardiol 1982;2: 153–159.Google Scholar
14.Deeg, KH, Hofbeck, M, Singer, H. Diagnosis of subclavian steal in infants with coarctation of the aorta and interruption of the aortic arch by color-coded Doppler sonography.J Ultrasound Med 1993;12:713–718.Google Scholar
15.Edwards, JE. Annomalies of the derivatives of the aortic arch system. Med Clin North Am 1948; 32:925–949CrossRefGoogle Scholar
16.Van Mierop, LHS, Kutsche, LM. cardiovascular anomalies in DiGeeorge syndrome and importance of neural crest as a possible pathogenetic factor. Am J Cardiol 1986; 58:133–137.CrossRefGoogle ScholarPubMed
17.Revich, M, Holling, HE, Roberts, B, Toole, JF. Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 1961;265:878–885.CrossRefGoogle Scholar
18.Gonzales, L, Weintraub, RA, Wiot, JF. Retrograde vertebral artery blood flow: a normal phenomenon. Radiology 1964;82: 211–216.Google Scholar
19.Lodge, FA, Lamberti, JJ, Goodman, AH, Kirpatrick, SE, George, L, Mathewson, JL, Waldman, JD. Vascular consequences of subclavian artery transection for the treatment of congential disease. J Thorac Cardiovasc Surg. 1983;86:18–23.Google Scholar
20.Folger, GM, Shah, KD. Subclavian steal in patients with Blalock-Taussig anastomosis. Circulation 1965;31:241–248.CrossRefGoogle ScholarPubMed
21.Marshall, RJ, Mantini, EL. Dynamics of the collateral circulation in patiens with subclavian steal. Circulation 1965;31:249–254.CrossRefGoogle Scholar
22.Nair, SK, Subramanyam, R, Venkiachalam, CG, Valiathan, MS. Right aortic arch with isolation of the left subclavian artery and bilateral patent ductus arterioses. J Cardiovasc Surg 1992;33:242–244.Google ScholarPubMed