Qiu Yumin, Wu Xiaoxin, Zhuang Zhuokai, Li Xiaozhi, Zhu Lei, Huang Cijun, Zhuang Hongjie, Ma Mingjian, Ye Feng, Chen Jing, Wu Zhiying, Yu Xiaopei, An Mingjie, Chen Rui, Chen Junyu, Guan Lizhi, Sang Hanyi, Ye Yuyang, Han Yueyin, Chen Zhuokai, Qin Han, Zhu Haoshuai, Zhou Yingying, Zilundu Prince L M, Xu Dazheng, Zhou Lihua
Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
Department of Cardiac Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou City, China.
Interact Cardiovasc Thorac Surg. 2019 Apr 1;28(4):622-628. doi: 10.1093/icvts/ivy296.
The aim of this study is to determine the incidence and explore the types of aortic arch branch variations found in our cadavers.
The types and incidence of aortic branch variations in 120 cadavers were analysed after careful dissection.
One hundred and six of 120 cadavers had normal aortic arch branches and gave rise to usual branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The remaining 14 cadavers had 2 basic types of branch variations, thus accounting for an incidence of 11.67%. A total of 9 aortic arches emitted 4 branches; the brachiocephalic trunk, the left common carotid artery, the left vertebral artery and the left subclavian artery (incidence 7.5%). The second subgroup of 5 cadavers also emitted 4 aortic branches: the right common carotid artery, the left common carotid artery, the left subclavian artery and the right subclavian artery (incidence 4.16%). In this group, the right subclavian artery sprung as a distal branch of the aortic arch (descending), thus making a vascular ring that takes a superoposterior course round the back of the trachea and the oesophagus to reach the right side. There was a single cadaver, different from the other 4 aortic branches of the second group which had a common origin for the common carotid arteries, while the left subclavian artery and distally placed right subclavian artery were present. We did not observe any Kommerell's aortic diverticula.
The variations of aortic arch branching are complex and diverse due to varied possible alterations in the embryological processes. There is an imperative need for further research on these variations to elucidate the possible relationships with clinical diagnostic or surgical events.
本研究旨在确定我们所解剖尸体中主动脉弓分支变异的发生率，并探究其类型。
对120具尸体进行仔细解剖后，分析主动脉分支变异的类型和发生率。
120具尸体中有106具主动脉弓分支正常，发出常见分支，即头臂干、左颈总动脉和左锁骨下动脉。其余14具尸体有2种基本类型的分支变异，发生率为11.67%。共有9个主动脉弓发出4个分支：头臂干、左颈总动脉、左椎动脉和左锁骨下动脉（发生率7.5%）。第二组的5具尸体也发出4个主动脉分支：右颈总动脉、左颈总动脉、左锁骨下动脉和右锁骨下动脉（发生率4.16%）。在该组中，右锁骨下动脉作为主动脉弓（降部）的远端分支发出，从而形成一个血管环，该血管环呈后上方向围绕气管和食管后方到达右侧。有1具尸体与第二组的其他4具尸体不同，其颈总动脉有共同起源，同时存在左锁骨下动脉和位置靠远的右锁骨下动脉。我们未观察到任何Kommerell主动脉憩室。
由于胚胎发育过程中可能存在多种变化，主动脉弓分支的变异复杂多样。迫切需要对这些变异进行进一步研究，以阐明其与临床诊断或手术事件之间可能存在的关系。
