Isolated left brachiocephalic artery with the right aortic a
Introduction:
Aortic arch anomalies include multiple entities, more common ones being anomalous branching patterns such as common brachiocephalic arteries, aberrant right subclavian artery, right aortic arch, and vascular rings. Overall arch anomalies constitute around 15%–20% of congenital heart diseases.[1] Isolation of arch vessels from the arch is distinctly uncommon.[2] Isolation of the left subclavian with the right aortic arch is the most common arch anomaly of the above-mentioned type and is frequently associated with other intracardiac anomalies.[3] We report an extremely rare case of isolated left brachiocephalic artery with the right aortic arch without associated intracardiac defects.

Case:
A 9-year-old male child presented to us with a history of dyspnea on exertion (New York Heart Association-II), palpitations on exertion, and failure to gain weight. The symptoms onset dated back to early childhood. Furthermore, there was a history of recurrent lower respiratory tract infections during infancy and early childhood. There was no history of cyanosis, spells, or squatting episodes. The patient was born of nonconsanguineous marriage, and his birth and developmental history were normal, except for poor weight gain. He had three elder siblings and all of them were healthy. Before coming to us, he was evaluated at a local hospital and was diagnosed with a large patent ductus arteriosus (PDA) with pulmonary artery hypertension and was referred for further management....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241852/
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