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Arıkan AA, Omay O, Çakır Ö, Cesur S, Çardaközü T, Durmaz A, Küçük B, Kanko M. A Pseudocoarctation of the Aorta With a Left Subclavian Artery Aneurysm, A Case Report and A Review of the Literature. Vasc Endovascular Surg 2021; 55:889-896. [PMID: 34142624 DOI: 10.1177/15385744211022536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Here we present a 47-year-old male diagnosed with a pseudocoarctation of the aorta and a funnel-like subclavian artery aneurysm with a large orifice and severe aortic valve insufficiency. The patient underwent a two-stage repair for both pathologies. After an aortic valve replacement, postcardiotomy pericardial effusion occurred and was medically managed. Six months later, the patient underwent a distal arcus aorta and subclavian artery replacement with a left posterolateral thoracotomy as the second stage. Due to the strict adhesions, pulmonary veins were not cannulated and an extracorporeal bypass between the pulmonary artery and femoral artery was used for distal body perfusion. The coincidence of subclavian aneurysms and a pseudocoarctation of the aorta is rare and a literature review was performed to identify treatment options for this pathology.
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Affiliation(s)
- Ali Ahmet Arıkan
- Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Oğuz Omay
- Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Özgür Çakır
- Department of Radiology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Sevim Cesur
- Department of Anesthesiology and Reanimation, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Tülay Çardaközü
- Department of Anesthesiology and Reanimation, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Ayşegül Durmaz
- Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Burhan Küçük
- Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Muhip Kanko
- Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey
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Yamamuro H, Ichikawa T, Hashimoto J, Ono S, Nagata Y, Kawada S, Kobayashi M, Koizumi J, Shibata T, Imai Y. Congenital anomalies of the left brachiocephalic vein detected in adults on computed tomography. Jpn J Radiol 2017; 35:597-605. [PMID: 28849388 DOI: 10.1007/s11604-017-0673-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/28/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Anomalous left brachiocephalic vein (BCV) is a rare and less known systemic venous anomaly. We evaluated congenital anomalies of the left BCV in adults detected during computed tomography (CT) examinations. MATERIALS AND METHODS This retrospective study included 81,425 patients without congenital heart disease who underwent chest CT. We reviewed the recorded reports and CT images for congenital anomalies of the left BCV including aberrant and supernumerary BCVs. The associated congenital aortic anomalies were assessed. RESULTS Among 73,407 cases at a university hospital, 22 (16 males, 6 females; mean age, 59 years) with aberrant left BCVs were found using keyword research on recorded reports (0.03%). Among 8018 cases at the branch hospital, 5 (4 males, 1 female; mean age, 67 years) with aberrant left BCVs were found using CT image review (0.062%). There were no significant differences in incidences of aberrant left BCV between the two groups. Two cases had double left BCVs. Eleven cases showed high aortic arches. Two cases had the right aortic arch, one case had an incomplete double aortic arch, and one case was associated with coarctation. CONCLUSION Aberrant left BCV on CT examination in adults was extremely rare. Some cases were associated with aortic arch anomalies.
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Affiliation(s)
- Hiroshi Yamamuro
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan.
| | - Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Jun Hashimoto
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Shun Ono
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Yoshimi Nagata
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Shuichi Kawada
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Makiko Kobayashi
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Jun Koizumi
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Takeo Shibata
- Department of Molecular Life Sciences, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Japan
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine, 259-1193, 143 Shimokasuya, Isehara, 259-1193, Japan
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Makani S, Mitchell J, Metton O, Di Filippo S, Henaine R, Ninet J. Surgical repair of a pseudocoarctation with cervical aortic arch complicated by multiple aneurysms of the aorta: a case report. Pan Afr Med J 2017; 26:236. [PMID: 28690750 PMCID: PMC5491740 DOI: 10.11604/pamj.2017.26.236.11800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 02/01/2017] [Indexed: 11/11/2022] Open
Abstract
Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and deformity of the aortic arch and is known to be associated with aneurysmal formation. Several studies unite to say it leads to a surgical sanction as soon as symptomatic or associated with aneurysms of the aortic arch. Our patient is a 12 years old boy, followed since birth for a little tight pseudocoarctation with a cervical aortic arch and transverse aortic arch hypoplasia. Close clinical and paraclinical monitoring including angioscans, showed the gradual enlargement of the superior mediastinum, in relation with the appearance of three aneurysms of the aortic arch. The intervention, performed by sternotomy, has consisted of the resection of the aneurysmal area and the interposition of a Dacron tube to repair the aortic arch and the reimplantation of the left subclavian artery into the left carotid artery. The postoperative course was uneventful. Management of pseudocoarctation associated with cervical aortic arch and aneurysms remains surgical. Close monitoring of patients with pseudocorctation, seems to be essential to avoid fatal complications such as aneurysmal rupture.
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Affiliation(s)
- Said Makani
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Julia Mitchell
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Olivier Metton
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Sylvie Di Filippo
- Department of Paediatric and Congenital Cardiology, Louis Pradel Hospital, Bron, Lyon, France
| | - Roland Henaine
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
| | - Jean Ninet
- Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France
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4
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Kimura K, Ohtake H, Kato H, Yashiki N, Tomita S, Watanabe G. Pseudocoarctation of the aorta complicated by thoracic aortic aneurysm. Asian Cardiovasc Thorac Ann 2011; 19:265-7. [DOI: 10.1177/0218492311407782] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pseudocoarctation is a rare anomaly involving kinking or buckling of the aorta without a pressure gradient across the lesion, considered to be a benign entity warranting no specific intervention. An uncommon case of pseudocoarctation associated with aortic aneurysm formation in 21-year-old woman is described. Pathological findings suggested that the etiology was anomalous development of the aorta in association with pseudocoarctation; therefore, careful follow-up of patients affected by pseudocoarctation is mandatory.
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Affiliation(s)
- Keiichi Kimura
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroshi Ohtake
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroki Kato
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Noriyoshi Yashiki
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shigeyuki Tomita
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Go Watanabe
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan
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6
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Konstantinov IE, Van Arsdell GS, O'Blenes S, Roy N, Campbell A. Retroaortic innominate vein with coarctation of the aorta: surgical repair and embryology review. Ann Thorac Surg 2003; 75:1014-6. [PMID: 12645739 DOI: 10.1016/s0003-4975(02)04333-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A newborn girl with a retroaortic innominate vein, coarctation of the aorta, ventricular septal defect, and subaortic stenosis underwent a complete repair at 8 days of age. The ascending aorta was transected and the innominate vein was brought in front of it. We review the anatomy and embryology of this rare entity and describe the surgical technique to avoid recoarctation and innomante vein compression.
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MESH Headings
- Anastomosis, Surgical
- Aorta, Thoracic/embryology
- Aorta, Thoracic/surgery
- Aortic Coarctation/embryology
- Aortic Coarctation/surgery
- Aortic Stenosis, Subvalvular/embryology
- Aortic Stenosis, Subvalvular/surgery
- Blood Vessel Prosthesis Implantation
- Brachiocephalic Veins/abnormalities
- Brachiocephalic Veins/embryology
- Brachiocephalic Veins/surgery
- Echocardiography
- Female
- Heart Defects, Congenital/embryology
- Heart Defects, Congenital/surgery
- Heart Septal Defects, Ventricular/embryology
- Heart Septal Defects, Ventricular/surgery
- Humans
- Infant, Newborn
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Affiliation(s)
- Igor E Konstantinov
- Division of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
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7
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Sakai O, Yamagishi M, Shuntoh K, Okano T, Yamada Y, Fujiwara K, Kitamura N. Critical aneurysmal dilatation of congenital kinking of the aorta. J Thorac Cardiovasc Surg 2001; 122:832-3. [PMID: 11581627 DOI: 10.1067/mtc.2001.115414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- O Sakai
- Department of Pediatric Cardiovascular Surgery, Children&'s Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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8
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Galeote G, Oliver JM, Domínguez FJ, Fuertes J, Calvo L, Sobrino JA. [Aortic pseudocoarctation complicated by a giant pseudoaneurysm]. Rev Esp Cardiol 2000; 53:287-9. [PMID: 10734760 DOI: 10.1016/s0300-8932(00)75092-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pseudocoarctation of the aorta is an infrequent anomaly caused by the elongation and the congenital kinking of the aorta. We present a case of pseudocoarctation of the aorta with saccular aneurysm complicated with a large pseudoaneurysm. Both, magnetic resonance and aortography showed an aneurysm of the aortic isthmus that extended/progressed as pseudoaneurysm towards the neck. The patient was asymptomatic but due to the high risk of rupture, she underwent surgical reparation. The revision of the literature and our experience with this case show that pseudocoarctation of the aorta is not always a benign pathology and that surgical reparation should be performed in all those cases that are complicated by aneurysm.
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Affiliation(s)
- G Galeote
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid.
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9
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Taneja K, Kawlra S, Sharma S, Rajani M. Pseudocoarctation of the aorta: complementary findings on plain film radiography, CT, DSA, and MRA. Cardiovasc Intervent Radiol 1998; 21:439-41. [PMID: 9853156 DOI: 10.1007/s002709900297] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- K Taneja
- Department of Cardiovascular Radiology CT Centre, All India Institute of Medical Sciences, New Delhi, India
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10
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Affiliation(s)
- J Lindsay
- Section of Cardiology, Washington Hospital Center, George Washington University School of Medicine, Washington, DC, USA
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11
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Grigsby JL, Galbraith T, Shurmur S, Deligonul U. Pseudocoarctation of the aorta complicated by saccular aneurysm: treatment by aortic arch replacement. Am Heart J 1996; 131:200-2. [PMID: 8554012 DOI: 10.1016/s0002-8703(96)90073-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- J L Grigsby
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-2265, USA
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12
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Soler R, Pombo F, Bargiela A, Gayol A, Rodríguez E. MRI of pseudocoarctation of the aorta: morphological and cine-MRI findings. Comput Med Imaging Graph 1995; 19:431-4. [PMID: 8734782 DOI: 10.1016/0895-6111(95)00021-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report a case of pseudocoarctation of the thoracic aorta diagnosed by magnetic resonance imaging. Morphological spin-echo findings and cine-MRI performed by gradient-echo multiphase images are reported. No other more invasive examinations were needed to establish the diagnosis of pseudocoarctation and to differentiate from other aortic abnormalities.
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Affiliation(s)
- R Soler
- Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain
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13
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Kessler RM, Miller KB, Pett S, Wernly JA. Pseudocoarctation of the aorta presenting as a mediastinal mass with dysphagia. Ann Thorac Surg 1993; 55:1003-5. [PMID: 8466315 DOI: 10.1016/0003-4975(93)90137-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Pseudocoarctation is an uncommon anomaly thought to be caused by congenital elongation and kinking of the aorta. We report a case of pseudocoarctation of the aorta presenting as a superior mediastinal mass causing dysphagia. Aortography and echocardiography revealed dilatation of the aorta and an aneurysm below the level of the pseudocoarctation. The patient underwent operative repair of the pseudocoarctation and associated aneurysm with good symptomatic relief. Review of the literature and experience with this case demonstrate that pseudocoarctation of the aorta cannot necessarily be regarded as a benign condition. Surgical treatment is recommended for all symptomatic patients and for those with associated aneurysm formation.
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Affiliation(s)
- R M Kessler
- Division of Thoracic and Cardiovascular Surgery, University of New Mexico School of Medicine, Albuquerque
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14
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Briley M. Case of the month: an unexpected twist. Br J Radiol 1993; 66:273-4. [PMID: 8472125 DOI: 10.1259/0007-1285-66-783-273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- M Briley
- Radiology Department, John Radcliffe Hospital, Headington, Oxford, UK
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15
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Bartoli JM, Chagnaud C, Moulin G, Di Stefano-Louineau D, Bory M, Kasbarian M. Pseudocoarctation of the aorta associated with retro-aortic left brachiocephalic vein: a case report. Surg Radiol Anat 1990; 12:307-9. [PMID: 2096468 DOI: 10.1007/bf01623712] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The authors report a case of pseudocoarctation of the aorta associated with a retro-aortic left brachiocephalic vein. This exceptional congenital malformation, never described before, was studied by aortography, computed tomography and magnetic resonance imaging.
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Affiliation(s)
- J M Bartoli
- Department of Radiology, CHU Timone, Marseille, France
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Tsai LM, Fu M, Chang CH, Hung JS. Figure-eight kinking of the aorta (pseudocoarctation) coexistent with coarctation. Chest 1990; 97:1239-40. [PMID: 2331920 DOI: 10.1378/chest.97.5.1239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An asymptomatic young man presented with a cardiac murmur and hypertension only in the right arm. Angiograms showed kinking of the aortic arch with a figure-eight appearance consistent with pseudocoarctation. Before the kinked segment, also demonstrated were a stenotic lesion in the aortic arch proximal to the left carotid artery and profound collateral circulations in the right thorax. These findings strongly suggested a rare combination of pseudocoarctation and true coarctation. His hypertension was corrected following surgery with a bypass graft between the ascending aorta and the abdominal aorta.
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Affiliation(s)
- L M Tsai
- Section of Cardiology, Chang Gung Medical College, Taiwan, Republic of China
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Abstract
We report a case of a 50-year-old man with pseudocoarctation of the aorta that we examined with magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). The MR images demonstrated the characteristic "kink" of the aorta and the absence of true coarctation. These appearances were confirmed by DSA, but we believe MRI to be the better method for examining the aorta because it is non-invasive and has the ability to display the mediastinal anatomy in the sagittal plane, in addition to the axial and coronal planes.
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Affiliation(s)
- J R LePage
- Oral Roberts University School of Medicine, Tulsa, Oklahoma 74137
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Vaid Y, Shin MS, Soto B. Role of computed tomography in nonobstructive coarctation. THE JOURNAL OF COMPUTED TOMOGRAPHY 1987; 11:95-8. [PMID: 3802885 DOI: 10.1016/0149-936x(87)90041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Two cases of nonobstructive or pseudocoarctation of aorta evaluated by computed tomography are presented. Clinical features along with chest radiography and computed tomography findings provided specific information, making further workup by catheterization and angiography unnecessary. As most cases of nonobstructive coarctation are asymptomatic and require no treatment, its recognition is of great practical importance.
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Abstract
Roentgenographic studies, including plain chest roentgenography, thoracic aortography, and coronary angiography, were performed in seven adult patients with nonobstructive coarctation, a congenital deformity of the upper thoracic aorta. The chest roentgenographic findings were compared with those of ten patients with obstructive coarctation studied during the same period. A great similarity was found in the morphology and associated lesions of these two conditions, which supports the idea that nonobstructive and obstructive coarctation are stages of the same disease. Patients with nonobstructive coarctation had a more prominent aortic arch, and the indentation in the thoracic aorta was higher than in patients with obstructive coarctation. In addition, patients with nonobstructive coarctation had no rib notching on plain chest roentgenograms. Angiographic evaluation in patients with nonobstructive disease demonstrated the anatomic lesion, the absence of collateral circulation, and the commonly associated anomalies of the aortic valve.
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