Department of Cardiovascular Surgery and Heart Transplantation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Card Surg. 2021 Jul;36(7):2467-2475. doi: 10.1111/jocs.15525. Epub 2021 Apr 12.
Interrupted aortic arch (IAA) is defined as a complete interruption of aortic lumen between the ascending and descending aorta. It is an uncommon and complicated congenital heart disease. It is rare for patients with isolated IAA to survive to adulthood without operation. Here we present three rare cases with isolated IAA together with a review of the literature of IAA. Besides, we reviewed reported adult cases with isolated IAA in the last 20 years and summarized the relevant data of the isolated type.
We retrospectively searched the hospital databases for adult patients with isolated IAA diagnosed at the Wuhan Union Hospital over the past 10 years. Cases related to adult isolated IAA published in last 20 years were identified by searching Pubmed.
Three adult patients with isolated IAA were identified. Two were referred to us for hypertension management and were diagnosed with IAA. They declined surgical treatments and took antihypertensive medications. One patient was referred to our hospital for further treatment options after diagnosed with IAA at another hospital. He received an extra-anatomic bypass surgery. But his hypertension did not well resolve after surgery, and was subsequently managed by anti-hypertensives medications. 25 published adult patients with isolated IAA were identified in Pubmed and relevant details were summarized.
Adult patients with isolated IAA usually have extensive collateral vessels joining the descending aorta. Anti-hypertensives medical management with long-term follow-up appears to be a reasonable treatment option for these patients, although surgical intervention is a good choice.
主动脉弓中断（IAA）定义为升主动脉和降主动脉之间主动脉管腔的完全中断。它是一种罕见且复杂的先天性心脏病。孤立性 IAA 患者在未经手术的情况下成年后存活的情况极为罕见。在此，我们报告了三例罕见的孤立性 IAA 病例，并回顾了 IAA 的文献。此外，我们回顾了过去 20 年中报道的孤立性 IAA 的成人病例，并总结了孤立型的相关数据。
我们通过检索武汉协和医院过去 10 年的医院数据库，对诊断为孤立性 IAA 的成年患者进行了回顾性研究。通过在 Pubmed 上搜索，确定了过去 20 年中与孤立性 IAA 相关的成人病例。
共发现 3 例孤立性 IAA 成年患者。其中 2 例因高血压就诊，诊断为 IAA。他们拒绝手术治疗，服用了降压药物。另 1 例患者在另一家医院诊断为 IAA 后转我院寻求进一步治疗方案，接受了体外旁路手术。但他的高血压手术后并未得到很好的缓解，随后仍需要服用降压药物进行治疗。在 Pubmed 上共确定了 25 例孤立性 IAA 的成人病例，并总结了相关细节。
孤立性 IAA 的成年患者通常有广泛的侧支血管连接降主动脉。长期随访的降压药物治疗似乎是这些患者的合理治疗选择，尽管手术干预是一个很好的选择。
