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Left subclavian to descending aorta bypass: A less invasive extra‐anatomical solution for a type A interrupted aortic arch
Author(s) -
Garcia Christopher,
Rey Jorge,
Lopez Alberto,
Lamelas Joseph,
OrozcoSevilla Vicente
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14173
Subject(s) - medicine , aortic arch , descending aorta , left subclavian artery , common carotid artery , aorta , thoracic aorta , interrupted aortic arch , subclavian artery , lumen (anatomy) , cardiology , surgery , carotid arteries
Abstract Interrupted aortic arch (IAA) is defined as a discontinuity of the aortic lumen from the aortic arch to the descending aorta. The incidence of this congenital malformation is three per million live births. It represents about 1.5% of congenital cardiac abnormalities. The classification system for IAA is divided into three distinct categories—type A: interruption of the lumen distal to the left subclavian artery, occurring in 43% cases; type B: interruption between the left carotid and left subclavian arteries, occurring in 53% cases (the most common); and type C: interruption between the innominate and left carotid, occurring in 4% cases. We describe the case of a 47‐year‐old woman who had a symptomatic type A IAA. A single‐stage extra‐anatomic bypass was performed between the left subclavian and the descending thoracic aorta using a 14 mm Dacron graft. The use of this approach is an option to solve this challenging clinical problem.