Z score - Aortic Arch

PHN values are in Red

(Click on the image to enlarge)

 

Aortic arch anomalies - Vascular ring (Developmental basis)

Images are from Freedom's CHD Textbook of Angiography Vol. II (1997) p.948.

Based on Edwards Hypothetical Double Arch.

Numbers in lower diagram indicate possible sites of regression. Vascular anomalies occur according to the site of regression.

Normal left arch - 1, 7 regress.

Right arch with mirror-image branching - 2,8 regress.

Left arch with aberrant RSCA - 1, 3 regress.

Right arch with aberrant LSCA - 2,6 regresss.

Figure out other vascular anomalies...similarly:

   Double arch - both arches patent

   Double arch with atresia of a segement of left arch

   Double arch with atresia of a segement of right arch

   Left arch with right descending aorta

   Left arch with isolation of RSCA

   Right arch with left ductus (retroesophageal)

   Right arch with isolation of LSCA

   Right arch with aberrant left innominate artery

   Right arch with isolation of left innominate artery

Anatomy: Left Aortic Arch with Right Descending Aorta

Left Aortic Arch with Right Descending Aorta: Possible type
(From Esophagography in anomalies of the aortic arch system by A.C. Klinkhamer. 1969. Williams & Wilkins Company, Baltimore, MD)
See related posting

Marfans Syndrome: Aortic Root Normal Values

Roman MJ et al. AJC 1989;64:507-512
(Also see newer nomogram from Parisian Children - AJC 2010;105:888-94)

Echo: What is shown by black arrow?

Clue: This is a 3 month old baby who has had Right modified BT shunt for DORV, d-TGA, Pulmonary atresia. Aortic arch is shown from suprasternal notch view.

Vascular Ring Analysis using Edwards Hypothetic Aortic Arches

Moss and Adams (Fifth Edition)

Persistent fifth arch

Dr. Thapar's patient from 1991:
Persistent fifth arch with Coarctation and TOF.

Images in Pediatric Cardiology:

Non-invasive Imaging of Isolated Persistent Fifth Aortic Arch.
SG Yang, et al. Pediatr Cardiol 2003;24:179-81.

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