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A Unique Case Of Branching Pattern In The Superior Mediastinum: A Brachiocephalic Trunk With Four Branches, And The Left Thyrocervical Trunk Arising From The Aortic Arch
Author(s) -
Carro Natalia Valentin,
Tavares Wilson Veras
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.557.5
Subject(s) - trunk , aortic arch , anatomy , branching (polymer chemistry) , medicine , mediastinum , arch , atlas (anatomy) , aorta , surgery , biology , engineering , structural engineering , materials science , ecology , composite material
Variations of the aortic arch are well known and have been demonstrated by many researchers 1 . During a routine anatomical dissection of a female fetal thoracic region, we observed a cardiac malposition. Typically, the position of the apex of the heart is located at midclavicular line within the fifth intercostal space. In this case, the apex of the heart is deviated to the midline of the thorax, pointing to the midline of the abdomen, corresponding to a mesocardia. Also, a unique variation of the aortic arch was present. In the anatomical literature, the most common configuration of the branching pattern of the aortic arch is comprised of three great vessels; the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. In this case, the aortic arch is giving rise to the brachiocephalic trunk, the thyrocervical trunk, and the left subclavian artery instead of what is described in anatomy textbooks. Additionally, the brachiocephalic trunk has four branches arising in the following sequence: the right subclavian, the right common carotid, the thyroid ima, and the left subclavian arteries. The branching pattern of the aortic arch and the brachiocephalic trunk described in this case has not been yet reported in the anatomical literature. Knowledge of this variation is of great importance for radiologists, head and neck and cardiothoracic surgeons, because presence of these variations may cause dangerous complications during procedures in the root of neck and superior mediastinum. Support or Funding Information The project described was supported by: Title V PPOHA grant number PO31M105050 from the U.S. Department of Education to UCC. The content is solely the responsibility of the authors and does not necessarily represents the official views of the U.S. Department of Education. Also, Award Number R25GM110513 from the National Institute of General Medical Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences or the National Institutes of Health.Overview of the fetal thoracic region. (AA) Aortic Arch; (BT) Brachiocephalic trunk; (RtS) Right Subclavian artery; (RtCC) Right Common carotid artery; (TIma) Thyroid Ima artery; (LtCC) Left Common carotid artery; (TcT) Thyrocervical trunk; (LtS) Left Subclavian artery