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Carl L. Tommaso David A. Fullerton Ted Feldman Larry S. Dean Ziyad M. Hijazi Eric Horlick Bonnie H. Weiner Evan Zahn Joaquin E. Cigarroa Carlos E. Ruiz Joseph Bavaria Michael J. Mack Duke E. Cameron R. Morton Bolman III D. Craig Miller Marc R. Moon Debabrata Mukherjee Alfredo Trento Gabriel S. Aldea Emile A. Bacha 《The Journal of thoracic and cardiovascular surgery》2014
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Holmes KW Bluemke DA Vricella LA Ravekes WJ Kling KM Spevak PJ 《Pediatric cardiology》2006,27(3):316-320
The objective of this study was to determine if distortion of the left subclavian artery course distinguishes double aortic
arch with atretic left dorsal aorta from right aortic arch with mirror image branching. We performed a retrospective case
series at a tertiary care center. Twenty-six patients undergoing magnetic resonance imaging for suspicion of a vascular ring
were identified, 6 of whom had an atretic left dorsal aorta confirmed by surgical inspection. Six patients with the diagnosis
of right aortic arch with mirror image branching were identified for comparison. The course of the left subclavian artery
was assessed using surface-rendered magnetic resonance angiography (MRA) and axial fast spin echo images. All patients with
double aortic arch had clinical symptoms suggestive of esophageal or tracheal compression. Six patients had double aortic
arch, 3 of whom had an atretic left dorsal aorta. In these 3 patients, the branching patterns on MRA mimicked right aortic
arch mirror image branching except for the distortion of the initial course of the left subclavian artery. Surgical observation
confirmed the presence of an atretic left dorsal aorta that resulted in tension on the left subclavian artery pulling it posteriorly
and inferiorly and completing the vascular ring. Patients with right aortic arch mirror image branching demonstrated no such
subclavian artery distortion, and these patients did not have clinical symptoms suggestive of a vascular ring. Our results
demonstrate that left subclavian artery distortion due to traction by an atretic left arch is an important diagnostic finding
in the evaluation 6 patients with suspected vascular rings. 相似文献
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