Garcia Christopher, Rey Jorge, Lopez Alberto, Lamelas Joseph, Orozco-Sevilla Vicente
Division of Cardiothoracic and Vascular Surgery, University of Miami Miller School of Medicine, Miami, Florida.
J Card Surg. 2019 Oct;34(10):1117-1119. doi: 10.1111/jocs.14173. Epub 2019 Jul 25.
Interrupted aortic arch (IAA) is defined as a discontinuity of the aortic lumen from the aortic arch to the descending aorta. The incidence of this congenital malformation is three per million live births. It represents about 1.5% of congenital cardiac abnormalities. The classification system for IAA is divided into three distinct categories-type A: interruption of the lumen distal to the left subclavian artery, occurring in 43% cases; type B: interruption between the left carotid and left subclavian arteries, occurring in 53% cases (the most common); and type C: interruption between the innominate and left carotid, occurring in 4% cases. We describe the case of a 47-year-old woman who had a symptomatic type A IAA. A single-stage extra-anatomic bypass was performed between the left subclavian and the descending thoracic aorta using a 14 mm Dacron graft. The use of this approach is an option to solve this challenging clinical problem.
主动脉弓中断(IAA)被定义为从主动脉弓到降主动脉的主动脉管腔连续性中断。这种先天性畸形的发病率为每百万活产中有3例。它约占先天性心脏异常的1.5%。IAA的分类系统分为三个不同类别——A型:在左锁骨下动脉远端的管腔中断,见于43%的病例;B型:在左颈动脉和左锁骨下动脉之间中断,见于53%的病例(最常见);C型:在无名动脉和左颈动脉之间中断,见于4%的病例。我们描述了一名47岁有症状的A型IAA女性患者的病例。使用14毫米涤纶人工血管在左锁骨下动脉和胸降主动脉之间进行了单阶段解剖外旁路手术。采用这种方法是解决这一具有挑战性的临床问题的一种选择。