Interrupted Aortic Arch

• The absence of a segment of the DTA.
• Considered an extreme form of Coarctation of AO.

Type A Interrupted Ao Arch

• Away
• Interruption occurs just distal to the left subclavian artery.
• Needs PDA or Cyanotic to the lower limbs.

   

   

Type B Interrupted Ao Arch

• Between
• Interruption occurs just distal to the left common carotid artery and just proximal to the left subclavian artery
• Strongly associated with DiGeorge syndrome
• Needs PDA or cyanotic left arm and lower limbs. 

Type C Interrupted Ao Arch

• Close

• Interruption occurs just distal to the brachiocephalic artery

• Doppler of flow will look like a PDA flow rather than pulsatile

• Ascending Ao provides blood supply proximal to the interruption

• Blood supply distal to the interruption is provided by the MPA through the PDA

• Results in the distal Sats. Being decreased

• A left to right VSD is usually present, which tend to increase distal sats.

• Ductal dependent lesion: ductus supplies lower half of body

• Ductus is usually left sided

• Patient may be cyanotic ( pink upper body and blue lower body)

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Interrupted Ao Arch and Surgery

• PDA is ligated
• Proximal Ao is opened distal to the LSCA and attached to the distal Ao with an end-to-end anastomosis
• Other defects (VSD) is repaired
• Similar to COA repair