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Aortic Arch and Vascular Rings
Facts and Terms about the Aortic Arch and Vascular Rings
9
Medical
Professional
09/23/2013

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Cards

Term

Determining Arch Sidedness

Definition
  • Marker at 3 o'clock, drop tail to follow the innominate artery as it branches. 
  • If right-sided arch then turn to 6 o'clock, rather than 12 o'clock, when in the Supra sternal notch long.
Term

Branches of a Normal Ao Arch

Definition
  • Innonminate/Brachiocephalic Artery-Right Subclavian Artery and Right Common Carotid Artery
  • Left Common Carotid Artery
  • Left Subclavian Artery
Term

Cervical Ao Arch

Definition
  • Normal Variant
  • Elongation of the aortic arch into the neck above the clavicle

 

Term

Right Ao Arch

Definition
  • Aorta descends on the rt
  • Mirror image of left aortic arch
  • Left brachiocephalic-left common carotid and left subclavian artery
  • Right common carotid
  • Right subclavian artery
  • In isolation the right aortic arch is not clinically significant
  • Need to document in case of future procedures (ie. Surgeries)
  • Right arch: highly associated with Tetrology of Fallot
Term

Aberrant Subclavian Artery

Definition
  • The most common congenital vascular anomaly of the Ao Arch.
  • Rare anatomical variant of the origin of the right or left subclavian artery.
  • Left aortic arch: aberrant right subclavian artery.
  • Right aortic arch: aberrant left subclavian artery. Can create a vascular ring.  

 

 

Term

Vascular Ring

Definition
  • Ring of vessels that surround the trachea and esophagus
  • Causes compression of the trachea and esophagus
  • May have respiratory distress, stridor (usually newborns in for respiratory issue; almost like high pitched gasping) , trouble swallowing food
  • Can occur with a right or double aortic arch…not left arch  

 

 

Term

Vascular Ring-Right Ao Arch w/Aberrant Left SCA

Definition
  • Second most common vascular ring
  • Trachea and esophagus is surrounded by the arch, aberrant left subclavian artery and the ligumentus arteriousus coming off of the right subclavian artery
  • Treatment: cut the ligamentum arteriosus to relieve compression

 

 

 

Term

Vascular Ring-Double AO Arch

Definition
  • Most common vascular ring (40%)
  • Embryology: lack of regression of the left side of the embryonic double aortic arch
  • Persistence of the double arch causes compression of trachea and esophagus
  • Echo: needs to determine if the arch is a right or left dominant arch
  • Document where all of the branching vessels are located
  • Treatment: removal of the smaller aortic arch or sewing the smaller arch into the dominant arch 
Term

Vascular Ring-Pulmonary Sling

Definition
  • Left pulmonary artery arises from the RPA
  • Passes posteriorly between the trachea and esophagus-type of vascular ring 
  • Treatment: re-implantation of LPA into MPA
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