Atresia of the aortic arch in 4-year-old child: a clinical case study

A Case of Postnatal Aortic Arch Atresia

Background

Aortic arch atresia is a rare congenital cardiac defect that may occur after birth. Pregnant women with gestational diabetes mellitus may increase the risk of aortic arch atresia in newborns after birth.

Case Description

A 16-day-old infant was referred to our hospital on the 15th postnatal day after an interrupted or atretic aortic arch was discovered. No obvious abnormality was detected in the infant during the prenatal ultrasound. Laboratory tests showed elevated inflammatory marker levels. Transthoracic echocardiography showed stenosis of the transverse arch of the aorta and a blind end at the distal end of the left subclavian artery. During surgery, it was found that the isthmus of the aorta was uninterrupted but completely occluded due to inflammation.

Conclusion

This case demonstrates that type A interrupted aortic arch and coarctation of the aorta can be acquired after birth, and if coarctation of the aorta is complicated by inflammation or if the pregnant women have gestational diabetes mellitus, it can result in aortic arch atresia as the patient's condition worsens. It is advised to consider aortic arch atresia when imaging reveals type A interrupted aortic arch.

Congenital anomalies of the aortic arch

Congenital anomalies of the aortic arch include diverse subgroups of malformations that may be clinically silent or may present with severe respiratory or esophageal symptoms especially when associated with complete vascular rings. These anomalies may be isolated or may be associated with other congenital heart diseases. Volume rendered computed tomography (CT) and magnetic resonance angiography (MRA) help in preoperative surgical planning by providing information about the complex relationship of aortic arch and its branches to the trachea and esophagus. Three dimensional capabilities of both computed tomography angiography (CTA) and MRA are helpful in determining evidence of tracheal or esophageal compression or other high-risk features in patients with a complete vascular ring.