RESUMEN
Isolated left subclavian artery (ILSA) with right aortic arch is a rare vascular anomaly accounting for 0.8% in all right-sided aortic arch anomalies. We report a case of an isolated left subclavian artery with right aortic arch and a combination of subclavian as well as pulmonary steal in infant with Tetralogy of Fallot. We reviewed and summarized 50 similar cases reported in the literature over the last 30 years, in order to gain a thorough understanding of this rare anomaly.
Asunto(s)
Anomalías Cardiovasculares , Enfermedades Vasculares , Malformaciones Vasculares , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Humanos , Lactante , Arteria Subclavia/diagnóstico por imagen , Arteria Subclavia/cirugíaRESUMEN
We present a rare synchronous occurrence of tetralogy of Fallot, right aortic arch, and isolated left subclavian artery, highlighting potential clinical and therapeutic implications.
Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Aorta Torácica/anomalías , Aorta Torácica/diagnóstico por imagen , Arteria Subclavia/anomalías , Arteria Subclavia/diagnóstico por imagen , Tetralogía de Fallot/diagnóstico por imagen , Anomalías Múltiples/cirugía , Adolescente , Aorta Torácica/cirugía , Procedimientos Quirúrgicos Cardiovasculares/métodos , Humanos , Masculino , Arteria Subclavia/cirugía , Tetralogía de Fallot/cirugíaRESUMEN
Isolation of the subclavian artery is a rare aortic arch anomaly with fewer than 100 cases reported in the literature. Left subclavian artery isolation is seen in 0.8% of right aortic arches, and right subclavian artery isolation is seen four times less frequently. Other intracardiac or arch malformations are usually associated, among which tetralogy of Fallot is commonly described. We describe the presentation, preoperative imaging, surgical strategies, and outcomes of four patients with this rare condition and review the published literature. The embryological basis and interesting pathophysiology are also discussed. Surgical division and reimplantation of the isolated subclavian artery onto the aortic arch or common carotid artery is the treatment of choice, with good immediate and midterm outcomes.