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Erschienen in: Pediatric Radiology 1/2008

01.01.2008 | Pictorial Essay

Multislice CT angiography of interrupted aortic arch

verfasst von: Dong Hyun Yang, Hyun Woo Goo, Dong-Man Seo, Tae-Jin Yun, Jeong-Jun Park, In-Sook Park, Jae Kon Ko, Young Hwee Kim

Erschienen in: Pediatric Radiology | Ausgabe 1/2008

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Abstract

Interrupted aortic arch (IAA) is defined as complete luminal and anatomic discontinuity between the ascending and descending aorta. Because almost all patients with IAA become critically ill during the neonatal period, they should undergo urgent corrective surgery. This clinical urgency necessitates a fast and accurate noninvasive diagnostic method. Although echocardiography remains the primary imaging tool for this purpose, it is not always sufficient for planning surgical correction of IAA, principally due to a limited acoustic window and the inexperience of imagers. In this context, multislice CT angiography is regarded as an appropriate imaging technique complementary to echocardiography because it is fast, accurate, and objective for the diagnosis of IAA. In this article we describe what cardiac radiologists should know about IAA in their clinical practice, including clinicopathological features, CT features with contemporary surgical methods and postoperative complications, and differentiation from coarctation of the aorta and aortic arch atresia.
Literatur
1.
2.
Zurück zum Zitat Loffredo CA, Ferencz C, Wilson PD et al (2000) Interrupted aortic arch: an epidemiologic study. Teratology 61:368–375PubMedCrossRef Loffredo CA, Ferencz C, Wilson PD et al (2000) Interrupted aortic arch: an epidemiologic study. Teratology 61:368–375PubMedCrossRef
3.
Zurück zum Zitat Lewin MB, Lindsay EA, Jurecic V et al (1997) A genetic etiology for interruption of the aortic arch type B. Am J Cardiol 80:493–497PubMedCrossRef Lewin MB, Lindsay EA, Jurecic V et al (1997) A genetic etiology for interruption of the aortic arch type B. Am J Cardiol 80:493–497PubMedCrossRef
4.
Zurück zum Zitat Kreutzer J, Van Praagh R (2000) Comparison of left ventricular outflow tract obstruction in interruption of the aortic arch and in coarctation of the aorta, with diagnostic, developmental, and surgical implications. Am J Cardiol 86:856–862PubMedCrossRef Kreutzer J, Van Praagh R (2000) Comparison of left ventricular outflow tract obstruction in interruption of the aortic arch and in coarctation of the aorta, with diagnostic, developmental, and surgical implications. Am J Cardiol 86:856–862PubMedCrossRef
5.
Zurück zum Zitat Krishna CS, Bhan A, Sharma S et al (2005) Interruption of aortic arch in adults: surgical experience with extra-anatomic bypass. Tex Heart Inst J 32:147–150 Krishna CS, Bhan A, Sharma S et al (2005) Interruption of aortic arch in adults: surgical experience with extra-anatomic bypass. Tex Heart Inst J 32:147–150
6.
Zurück zum Zitat McCrindle BW, Tchervenkov CI, Konstantinov IE et al (2005) Risk factors associated with mortality and interventions in 472 neonates with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg 129:343–350PubMedCrossRef McCrindle BW, Tchervenkov CI, Konstantinov IE et al (2005) Risk factors associated with mortality and interventions in 472 neonates with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg 129:343–350PubMedCrossRef
7.
Zurück zum Zitat Backer CL, Mavroudis C (2000) Congenital Heart Surgery Nomenclature and Database Project: patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch. Ann Thorac Surg 69(4 Suppl):S298–S307PubMedCrossRef Backer CL, Mavroudis C (2000) Congenital Heart Surgery Nomenclature and Database Project: patent ductus arteriosus, coarctation of the aorta, interrupted aortic arch. Ann Thorac Surg 69(4 Suppl):S298–S307PubMedCrossRef
8.
Zurück zum Zitat Kaulitz R, Jonas RA, van der Velde ME (1999) Echocardiographic assessment of interrupted aortic arch. Cardiol Young 9:562–571PubMedCrossRef Kaulitz R, Jonas RA, van der Velde ME (1999) Echocardiographic assessment of interrupted aortic arch. Cardiol Young 9:562–571PubMedCrossRef
9.
Zurück zum Zitat Cinar A, Haliloglu M, Karagoz T et al (2004) Interrupted aortic arch in a neonate: multidetector CT diagnosis. Pediatr Radiol 34:901–903PubMedCrossRef Cinar A, Haliloglu M, Karagoz T et al (2004) Interrupted aortic arch in a neonate: multidetector CT diagnosis. Pediatr Radiol 34:901–903PubMedCrossRef
10.
Zurück zum Zitat Lee HY, Lee W, Chung JW et al (2006) Interrupted aortic arch with aberrant subclavian artery: a rare form of arch anomaly demonstrated with multidetector CT and 3D reconstruction. Pediatr Radiol 36:272–273PubMedCrossRef Lee HY, Lee W, Chung JW et al (2006) Interrupted aortic arch with aberrant subclavian artery: a rare form of arch anomaly demonstrated with multidetector CT and 3D reconstruction. Pediatr Radiol 36:272–273PubMedCrossRef
11.
Zurück zum Zitat Onbas O, Olgun H, Ceviz N et al (2006) Interrupted aortic arch associated with absence of left common carotid artery: imaging with MDCT. Cardiovasc Intervent Radiol 29:429–431PubMedCrossRef Onbas O, Olgun H, Ceviz N et al (2006) Interrupted aortic arch associated with absence of left common carotid artery: imaging with MDCT. Cardiovasc Intervent Radiol 29:429–431PubMedCrossRef
12.
Zurück zum Zitat Roche KJ, Krinsky G, Lee VS et al (1999) Interrupted aortic arch: diagnosis with gadolinium-enhanced 3D MRA. J Comput Assist Tomogr 23:197–202PubMedCrossRef Roche KJ, Krinsky G, Lee VS et al (1999) Interrupted aortic arch: diagnosis with gadolinium-enhanced 3D MRA. J Comput Assist Tomogr 23:197–202PubMedCrossRef
13.
Zurück zum Zitat Goo HW, Park IS, Ko JK et al (2003) CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics 23(Spec No):S147–S165PubMedCrossRef Goo HW, Park IS, Ko JK et al (2003) CT of congenital heart disease: normal anatomy and typical pathologic conditions. Radiographics 23(Spec No):S147–S165PubMedCrossRef
14.
Zurück zum Zitat Goo HW, Park IS, Ko JK et al (2005) Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging 21:347–365PubMedCrossRef Goo HW, Park IS, Ko JK et al (2005) Computed tomography for the diagnosis of congenital heart disease in pediatric and adult patients. Int J Cardiovasc Imaging 21:347–365PubMedCrossRef
15.
Zurück zum Zitat Gilkeson RC, Ciancibello L, Zahka K (2003) Pictorial essay. Multidetector CT evaluation of congenital heart disease in pediatric and adult patients. AJR 180:973–980PubMed Gilkeson RC, Ciancibello L, Zahka K (2003) Pictorial essay. Multidetector CT evaluation of congenital heart disease in pediatric and adult patients. AJR 180:973–980PubMed
16.
Zurück zum Zitat Lee T, Tsai IC, Fu YC et al (2006) Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experience in technical and clinical feasibility. Pediatr Radiol 36:1273–1282PubMedCrossRef Lee T, Tsai IC, Fu YC et al (2006) Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experience in technical and clinical feasibility. Pediatr Radiol 36:1273–1282PubMedCrossRef
17.
Zurück zum Zitat Goo HW, Park IS, Ko JK et al (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798PubMedCrossRef Goo HW, Park IS, Ko JK et al (2005) Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease. Pediatr Radiol 35:792–798PubMedCrossRef
18.
Zurück zum Zitat Goo HW, Suh DS (2006) Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation. Pediatr Radiol 36:344–351PubMedCrossRef Goo HW, Suh DS (2006) Tube current reduction in pediatric non-ECG-gated heart CT by combined tube current modulation. Pediatr Radiol 36:344–351PubMedCrossRef
19.
Zurück zum Zitat Russo V, Renzulli M, La Palombara C et al (2006) Congenital diseases of the thoracic aorta. Role of MRI and MRA. Eur Radiol 16:676–684PubMedCrossRef Russo V, Renzulli M, La Palombara C et al (2006) Congenital diseases of the thoracic aorta. Role of MRI and MRA. Eur Radiol 16:676–684PubMedCrossRef
20.
Zurück zum Zitat Goo HW, Yang DH, Park IS et al (2007) Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone Fontan operation or bidirectional cavopulmonary connection: initial experience. J Magn Reson Imaging 25:727–736PubMedCrossRef Goo HW, Yang DH, Park IS et al (2007) Time-resolved three-dimensional contrast-enhanced magnetic resonance angiography in patients who have undergone Fontan operation or bidirectional cavopulmonary connection: initial experience. J Magn Reson Imaging 25:727–736PubMedCrossRef
21.
Zurück zum Zitat Netter FH, Van Mierop LH (1978) Embryology. In: Netter FH (ed) The CIBA collection of medical illustrations (heart). Ciba Pharmaceutical, New York, pp 112–130 Netter FH, Van Mierop LH (1978) Embryology. In: Netter FH (ed) The CIBA collection of medical illustrations (heart). Ciba Pharmaceutical, New York, pp 112–130
22.
Zurück zum Zitat Lee JR, Kwak JG, Ban JE et al (2006) Analysis of the causes of and risk factors for mortality in the surgical repair of interrupted aortic arch. Korean J Thorac Cardiovasc Surg 39:99–105 Lee JR, Kwak JG, Ban JE et al (2006) Analysis of the causes of and risk factors for mortality in the surgical repair of interrupted aortic arch. Korean J Thorac Cardiovasc Surg 39:99–105
23.
Zurück zum Zitat McElhinney DB, Tworetzky W, Hanley FL et al (1999) Congenital obstructive lesions of the right aortic arch. Ann Thorac Surg 67:1194–1202PubMedCrossRef McElhinney DB, Tworetzky W, Hanley FL et al (1999) Congenital obstructive lesions of the right aortic arch. Ann Thorac Surg 67:1194–1202PubMedCrossRef
24.
Zurück zum Zitat Vriend JW, Lam J, Mulder BJ (2004) Complete aortic arch obstruction: interruption or aortic coarctation? Int J Cardiovasc Imaging 20:393–396PubMedCrossRef Vriend JW, Lam J, Mulder BJ (2004) Complete aortic arch obstruction: interruption or aortic coarctation? Int J Cardiovasc Imaging 20:393–396PubMedCrossRef
25.
Zurück zum Zitat Oosterhof T, Azakie A, Freedom RM et al (2004) Associated factors and trends in outcomes of interrupted aortic arch. Ann Thorac Surg 78:1696–1702PubMedCrossRef Oosterhof T, Azakie A, Freedom RM et al (2004) Associated factors and trends in outcomes of interrupted aortic arch. Ann Thorac Surg 78:1696–1702PubMedCrossRef
26.
Zurück zum Zitat Momma K, Ando M, Matsuoka R et al (1999) Interruption of the aortic arch associated with deletion of chromosome 22q11 is associated with a subarterial and doubly committed ventricular septal defect in Japanese patients. Cardiol Young 9:463–467PubMed Momma K, Ando M, Matsuoka R et al (1999) Interruption of the aortic arch associated with deletion of chromosome 22q11 is associated with a subarterial and doubly committed ventricular septal defect in Japanese patients. Cardiol Young 9:463–467PubMed
27.
Zurück zum Zitat Bove EL, Minich LL, Pridjian AK et al (1993) The management of severe subaortic stenosis, ventricular septal defect, and aortic arch obstruction in the neonate. J Thorac Cardiovasc Surg 105:289–295PubMed Bove EL, Minich LL, Pridjian AK et al (1993) The management of severe subaortic stenosis, ventricular septal defect, and aortic arch obstruction in the neonate. J Thorac Cardiovasc Surg 105:289–295PubMed
28.
Zurück zum Zitat al-Marsafawy HM, Ho SY, Redington AN et al (1995) The relationship of the outlet septum to the aortic outflow tract in hearts with interruption of the aortic arch. J Thorac Cardiovasc Surg 109:1225–1236PubMedCrossRef al-Marsafawy HM, Ho SY, Redington AN et al (1995) The relationship of the outlet septum to the aortic outflow tract in hearts with interruption of the aortic arch. J Thorac Cardiovasc Surg 109:1225–1236PubMedCrossRef
29.
Zurück zum Zitat Blatchford JW 3rd, Franciosi RA, Singh A et al (1987) Vascular ring in interruption of the aortic arch with bilateral patent ductus arteriosi. J Thorac Cardiovasc Surg 94:596–599PubMed Blatchford JW 3rd, Franciosi RA, Singh A et al (1987) Vascular ring in interruption of the aortic arch with bilateral patent ductus arteriosi. J Thorac Cardiovasc Surg 94:596–599PubMed
30.
Zurück zum Zitat Konstantinov IE, Karamlou T, Blackstone EH et al (2006) Truncus arteriosus associated with interrupted aortic arch in 50 neonates: a Congenital Heart Surgeons Society study. Ann Thorac Surg 81:214–222PubMedCrossRef Konstantinov IE, Karamlou T, Blackstone EH et al (2006) Truncus arteriosus associated with interrupted aortic arch in 50 neonates: a Congenital Heart Surgeons Society study. Ann Thorac Surg 81:214–222PubMedCrossRef
31.
Zurück zum Zitat Konstantinov IE, Karamlou T, Williams WG et al (2006) Surgical management of aortopulmonary window associated with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg 131:1136–1141PubMedCrossRef Konstantinov IE, Karamlou T, Williams WG et al (2006) Surgical management of aortopulmonary window associated with interrupted aortic arch: a Congenital Heart Surgeons Society study. J Thorac Cardiovasc Surg 131:1136–1141PubMedCrossRef
32.
Zurück zum Zitat Berry TE, Bharati S, Muster AJ et al (1982) Distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and hypoplasia of the aortic isthmus: a newly recognized syndrome. Am J Cardiol 49:108–116PubMedCrossRef Berry TE, Bharati S, Muster AJ et al (1982) Distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and hypoplasia of the aortic isthmus: a newly recognized syndrome. Am J Cardiol 49:108–116PubMedCrossRef
33.
Zurück zum Zitat Yoo SJ, Choi HY, Park IS et al (1991) Distal aortopulmonary window with aortic origin of the right pulmonary artery and interruption of the aortic arch (Berry syndrome): diagnosis by MR imaging. AJR 157:835–836PubMed Yoo SJ, Choi HY, Park IS et al (1991) Distal aortopulmonary window with aortic origin of the right pulmonary artery and interruption of the aortic arch (Berry syndrome): diagnosis by MR imaging. AJR 157:835–836PubMed
34.
Zurück zum Zitat De Caro E, Pongiglione G, Ribaldone D (1998) Interruption of the aortic arch, ventricular septal defect, aortic atresia and aortopulmonary fistulous communication. Int J Cardiol 65:19–21PubMedCrossRef De Caro E, Pongiglione G, Ribaldone D (1998) Interruption of the aortic arch, ventricular septal defect, aortic atresia and aortopulmonary fistulous communication. Int J Cardiol 65:19–21PubMedCrossRef
35.
Zurück zum Zitat Luciani GB, Ackerman RJ, Chang AC et al (1996) One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: a novel approach. J Thorac Cardiovasc Surg 111:348–358PubMedCrossRef Luciani GB, Ackerman RJ, Chang AC et al (1996) One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: a novel approach. J Thorac Cardiovasc Surg 111:348–358PubMedCrossRef
36.
Zurück zum Zitat Roussin R, Belli E, Lacour-Gayet F et al (2002) Aortic arch reconstruction with pulmonary autograft patch aortoplasty. J Thorac Cardiovasc Surg 123:443–448PubMedCrossRef Roussin R, Belli E, Lacour-Gayet F et al (2002) Aortic arch reconstruction with pulmonary autograft patch aortoplasty. J Thorac Cardiovasc Surg 123:443–448PubMedCrossRef
37.
Zurück zum Zitat Sakakibara Y, Gomi S, Mihara W et al (1999) Late aneurysm of the distal aortic arch after repair of aortic interruption. A case report. Jpn Heart J 40:497–501PubMedCrossRef Sakakibara Y, Gomi S, Mihara W et al (1999) Late aneurysm of the distal aortic arch after repair of aortic interruption. A case report. Jpn Heart J 40:497–501PubMedCrossRef
38.
Zurück zum Zitat Hirooka K, Fraser CD Jr (1997) Ross-Konno procedure with interrupted aortic arch repair in a premature neonate. Ann Thorac Surg 64:249–251PubMedCrossRef Hirooka K, Fraser CD Jr (1997) Ross-Konno procedure with interrupted aortic arch repair in a premature neonate. Ann Thorac Surg 64:249–251PubMedCrossRef
39.
Zurück zum Zitat Goo HW (2004) Evaluation of the airways in patients with congenital heart disease using multislice CT. J Korean Pediatr Cardiol Soc 8:37–43 Goo HW (2004) Evaluation of the airways in patients with congenital heart disease using multislice CT. J Korean Pediatr Cardiol Soc 8:37–43
40.
Zurück zum Zitat Sakai T, Miki S, Ueda Y et al (1995) Left main bronchus compression after aortic reconstruction for interruption of aortic arch. Eur J Cardiothorac Surg 9:667–669PubMedCrossRef Sakai T, Miki S, Ueda Y et al (1995) Left main bronchus compression after aortic reconstruction for interruption of aortic arch. Eur J Cardiothorac Surg 9:667–669PubMedCrossRef
41.
Zurück zum Zitat Pretre R, Friedli B, Rouge JC et al (1996) Anterior translocation of the right pulmonary artery to prevent bronchovascular compression in a case of truncus arteriosus and type A interrupted aortic arch. J Thorac Cardiovasc Surg 111:672–674PubMedCrossRef Pretre R, Friedli B, Rouge JC et al (1996) Anterior translocation of the right pulmonary artery to prevent bronchovascular compression in a case of truncus arteriosus and type A interrupted aortic arch. J Thorac Cardiovasc Surg 111:672–674PubMedCrossRef
42.
Zurück zum Zitat Epelman M, Navarro OM, Daneman A et al (2005) M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol 35:661–667PubMedCrossRef Epelman M, Navarro OM, Daneman A et al (2005) M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol 35:661–667PubMedCrossRef
Metadaten
Titel
Multislice CT angiography of interrupted aortic arch
verfasst von
Dong Hyun Yang
Hyun Woo Goo
Dong-Man Seo
Tae-Jin Yun
Jeong-Jun Park
In-Sook Park
Jae Kon Ko
Young Hwee Kim
Publikationsdatum
01.01.2008
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 1/2008
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0662-3

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