Petit A, Leca F, Chague F, Marot J P
Arch Mal Coeur Vaiss. 1986 Feb;79(2):249-52.
The authors report a case of type A interruption of the aortic arch with the subclavian arteries arising from the descending aorta which was of special interest because of the absence of a patent ductus arteriosus. Therefore, the systemic circulation was assured from the carotid arteries which perfused the vertebral arteries retrogradely via the circle of Willis. The association of a partial endocardial cushion defect and hypoplasia of the ventricle explained the surgical failure. A review of the literature of interruption of the aortic arch without a ductus confirmed that this was a rare condition and, paradoxically, well tolerated in the absence of associated malformations. On the other hand, the left ventricular lesions, usually present in the classical forms with patent ductus arteriosus, operated in the neonatal period, increase the operative risk.
作者报告了一例主动脉弓A型中断病例，其锁骨下动脉起源于降主动脉，由于未发现动脉导管未闭，该病例尤为引人关注。因此，体循环由颈动脉提供保障，颈动脉通过Willis环逆向灌注椎动脉。部分心内膜垫缺损与心室发育不全的关联解释了手术失败的原因。对无动脉导管的主动脉弓中断相关文献的回顾证实，这是一种罕见情况，而且矛盾的是，在无相关畸形时耐受性良好。另一方面，经典形式且伴有动脉导管未闭的左心室病变通常在新生儿期进行手术，这会增加手术风险。
