Isolated Subclavian Artery: A Rare Entity Revisited.
Isolation of the subclavian artery is a rare aortic arch anomaly with fewer than 100 cases reported in the literature. Left subclavian artery isolation is seen in 0.8% of right aortic arches, and right subclavian artery isolation is seen four times less frequently. Other intracardiac or arch malformations are usually associated, among which tetralogy of Fallot is commonly described. We describe the presentation, preoperative imaging, surgical strategies, and outcomes of four patients with this rare condition and review the published literature. The embryological basis and interesting pathophysiology are also discussed. Surgical division and reimplantation of the isolated subclavian artery onto the aortic arch or common carotid artery is the treatment of choice, with good immediate and midterm outcomes.
Department of Pediatric Cardiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India supratim80@gmail.com.
Supratim
S
Sen
Department of Pediatric Cardiac Surgery, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India.
Smrutiranjan
S
Mohanty
Department of Pediatric Cardiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India.
Snehal
S
Kulkarni
Department of Pediatric Cardiac Surgery, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India.
Suresh G
SG
Rao
D000015:Abnormalities, Multiple; D000293:Adolescent; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods; D035583:Rare Diseases; D013348:Subclavian Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D054079:Vascular Malformations / Q000175:diagnosis* / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods*
arch anomalies; isolated subclavian artery; pulmonary steal; subclavian steal; vertebrobasilar insufficiency