Due to the limited visualization of a possible aneurysm, an MR angiography was performed. The measurement of blood pressure showed an increase in systolic pressure difference currently of 30 mmHg between the right and the left arm. At the admission the patient did not show any symptoms related to the aortic arch aneurysm such as hoarseness of voice, shortness of breath, trouble swallowing or pain radiating to the back. The clinical assessment and echocardiography were performed during regular check-ups at the department for congenital cardiac diseases. Other than slight systolic pressure difference between the right and the left arm, the patient remained asymptomatic over the years. The VSD closure was performed four years later. At the age of four days corrective surgery was performed using a bovine umbilical graft of 8 mm in diameter to restore the aortic arch, followed by ligation of ductus Botalli and banding of pulmonal artery via right thoracotomy. She was diagnosed with type B IAA with concomitant VSD at birth. in 1980 ( 6).Ī 39-year-old female presented with aneurysm of distal aortic arch after undergoing corrective surgery for IAA as a neonate. The initial case report describing the primary surgery was published by Wyler et al. Thirty-nine years later she is presenting with a dilatation of the xenograft and an aneurysm distal to it requiring a surgery. She underwent corrective surgery as a neonate where a bovine umbilical vascular graft was used for aortic arch repair. We present a follow-up case of a female patient with the history of IAA type B associated with right-sided descending aorta. Other not uncommon complications include residual VSD and left ventricular outflow tract (LVOT) obstruction especially subaortic stenosis which influence early and late survival ( 5). An obstruction of the graft is a common complication after the repair surgery with 45% occurrence within 5 years after the surgery ( 3). The current therapy for IAA constitutes establishing ductal patency by infusing prostaglandin E1 followed by a one-stage primary neonatal repair including establishing arch continuation via direct anastomosis or tube graft and, if present, VSD closure. If untreated, this condition remains lethal usually 4–10 days after birth ( 4). Further, it can be associated with genetic disorders, such as DiGeorge syndrome ( 4). IAA is often accompanied by further cardiac malformations such as ventricular septal defect (VSD) or interruption of the pulmonary artery. Type B represents the most common type with approximately 80% of the cases ( 3) with interruption occurring between subclavian and left carotid arteries. It is classified into three subtypes based on the level of interruption of the aortic arch ( 2). Interrupted aortic arch (IAA) is a rare cardiac malformation accounting for 1.5% of congenital cardiac anomalies ( 1). Keywords: Interrupted aortic arch (IAA) bovine umbilical vascular graft right-sided aorta descendens Interviews with Outstanding Guest Editors.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.
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