1. Non-invasive diagnosis of aortic arch anomalies in children – 15 years of own experience
- Author
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Maciej A. Karolczak, Marcin Myszkowski, Wojciech Mądry, and Ewa Zacharska-Kokot
- Subjects
Aortic arch ,medicine.medical_specialty ,lcsh:Medical technology ,Double aortic arch ,Kommerell’s diverticulum ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,right aortic arch ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,medicine.artery ,medicine ,echocardiography ,Radiology, Nuclear Medicine and imaging ,aberrant subclavian artery ,Computed tomography angiography ,lcsh:R5-920 ,Left aortic arch ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Non invasive ,Aortic arch anomalies ,double aortic arch ,medicine.disease ,Trunk ,lcsh:R855-855.5 ,030228 respiratory system ,cardiovascular system ,Medicine ,Radiology ,lcsh:Medicine (General) ,business - Abstract
Aim: To summarize our experience in echocardiographic diagnosis of aortic arch anomalies in pediatric patients. Materials and methods: A retrospective assessment of echocardiographic findings in Echo-Lab patients of the Pediatric Cardiac Surgery Department, who were diagnosed with an anomalous aortic arch between 2003 and 2018. Results: The diagnosis of an abnormal course of the aortic arch and/or its branches was established in 115 children aged between 4 days and 17 years. The following types of anomalies were detected: left aortic arch with aberrant right subclavian artery in 42 patients; right aortic arch with left brachiocephalic trunk in 14 patients; right aortic arch, aberrant left subclavian artery in 36 patients; double aortic arch in 14 patients; and other, more complex types in 9 patients. The main elements of defects were correctly identified by echo in all cases. We decided to additionally perform computed tomography angiography in 32 patients to clarify all details necessary to qualify patients for surgery and establish the surgical plan. Conclusions: 1. Echocardiography strictly following the pre-determined protocol has 100% sensitivity in the detection of basic elements of aortic arch anomaly and is a perfect tool for diagnostic process initiation. 2. Since it is not possible to visualize all anatomic details, the qualification for surgery should by based on computed tomography angiography or cardiac magnetic resonance imaging, which precisely visualize both abnormal vessels and compressed structures. Aim: To summarize our experience in echocardiographic diagnosis of aortic arch anomalies in pediatric patients. Materials and methods: A retrospective assessment of echocardiographic findings in Echo-Lab patients of the Pediatric Cardiac Surgery Department, who were diagnosed with an anomalous aortic arch between 2003 and 2018. Results: The diagnosis of an abnormal course of the aortic arch and/or its branches was established in 115 children aged between 4 days and 17 years. The following types of anomalies were detected: left aortic arch with aberrant right subclavian artery in 42 patients; right aortic arch with left brachiocephalic trunk in 14 patients; right aortic arch, aberrant left subclavian artery in 36 patients; double aortic arch in 14 patients; and other, more complex types in 9 patients. The main elements of defects were correctly identified by echo in all cases. We decided to additionally perform computed tomography angiography in 32 patients to clarify all details necessary to qualify patients for surgery and establish the surgical plan. Conclusions: 1. Echocardiography strictly following the pre-determined protocol has 100% sensitivity in the detection of basic elements of aortic arch anomaly and is a perfect tool for diagnostic process initiation. 2. Since it is not possible to visualize all anatomic details, the qualification for surgery should by based on computed tomography angiography or cardiac magnetic resonance imaging, which precisely visualize both abnormal vessels and compressed structures.
- Published
- 2019