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Persistent fifth aortic arch: the 'great pretender' in clinical practice
- Source :
- Cardiology in the young. 28(2)
- Publication Year :
- 2017
-
Abstract
- Persistence of the embryonic “fifth aortic arch” in postnatal life is a rare, enigmatic – and at times controversial – condition, with variable anatomical forms and physiological consequences. First described in humans over 40 years ago by Van Praagh, the condition was labelled the “great pretender” by Gerlis 25 years later, because of its apparent propensity to mimic anatomically similar structures. Despite many subsequent case reports citing the condition, the true developmental origin of these structures remains unresolved, and has been the subject of debate among embryologists for more than a century. A persistent fifth aortic arch has been defined as an extrapericardial structure, arising from the ascending aorta opposite or proximal to the brachiocephalic artery, and terminating in the dorsal aorta or pulmonary arteries via a persistently patent arterial duct. This description may therefore encompass various anatomical forms, such as a unilateral double-lumen aortic arch, an unrestrictive aortopulmonary shunt, or a critical vascular channel for either the systemic or pulmonary circulation. The physiological properties of these vessels, such as their response to prostaglandins, may also be unpredictable. In this article, we demonstrate a number of cases that fulfil the contemporary definition of “persistent fifth aortic arch” while acknowledging the embryological controversies associated with this term. We also outline the key diagnostic features, particularly with respect to the use of new cross-sectional imaging techniques.
- Subjects :
- Aortic arch
medicine.medical_specialty
Vascular Malformations
Coarctation of the aorta
Aortic Diseases
Fifth aortic arch
Aorta, Thoracic
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
03 medical and health sciences
Dorsal aorta
0302 clinical medicine
Imaging, Three-Dimensional
medicine.artery
Internal medicine
Ascending aorta
Brachiocephalic artery
Medicine
Humans
business.industry
General Medicine
medicine.disease
Shunt (medical)
Clinical Practice
Echocardiography
Pediatrics, Perinatology and Child Health
Cardiology
Cardiology and Cardiovascular Medicine
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 14671107
- Volume :
- 28
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Cardiology in the young
- Accession number :
- edsair.doi.dedup.....78af00eb02e25fa51a8c272d4620f4fa