主动脉弓变异.ppt

Development of Aortic Arch and great vessels Anatomical Categories Abnormalities of branching Normal L Aortic Arch Variants Abnormal L Aortic Arch Abnormalities of arch position 3. R Aortic Arch 4. Cervical Aortic Arch Superpneumarary arches 5. Double Aortic Arch 6. Persistent Fifth AA 7. Interrupted Aortic Arch 8. Anomalous origin of PA branches and other AA anomalies Clinical Classification Vascular rings Non ring vascular compression of trachea, bronchi, oesophagus Non compressive arch malformation Duct dependent arch anomalies Clinical features of vascular rings Stridor – increase with RTI Recurrent pneumonia/ bronchitis Hyperextension of neck (esp. in infants) Reflex apnoea associated with eating Swallowing difficulty Chocking of food Sidedness of Aortic arch L R aortic arch definitions Refers to which bronchus is crossed by the arch Normal – Cross the L main bronchus at T5 Branching…. general rule – 1st arch vessel contain a carotid a. contralateral to Ao A Importance of sidedness of Ao arch BT shunt – on side of In A Repair of oesophageal atresia – side opp arch Anatomical Categories Abnormalities of branching Normal L Aortic Arch Variants Abnormal L Aortic Arch Abnormalities of arch position 3. R Aortic Arch 4. Cervical Aortic Arch Superpneumarary arches 5. Double Aortic Arch 6. Persistent Fifth AA 7. Interrupted Aortic Arch 8. Anomalous origin of PA branches and other AA anomalies 1. Normal L Aortic Arch Variants Variants 1. Common brachiocephalic trunk Present in 10% of L arches No consequences 1. Normal L Aortic Arch Variants Variants 2. Separate origin of L vertebral a. from aortic arch (normal – from L subclavian) Size 12, 34 DD – anomalous R SCA Anatomical Categories Abnormalities of branching Normal L Aortic Arch Variants Abnormal L Aortic Arch Abnormalities of arch position 3. R Aortic Arch 4. Cervical Aortic Arch Superpneumarary arches 5. Double Aortic Arch 6. Persistent Fifth AA 7. Interrupted Aortic Arch 8. Anom