Login
Register
Reset Password
Publish & Distribute
Publishing Solutions
Distribution Solutions
Subjects
Architecture and Design
Arts
Business and Economics
Chemistry
Classical and Ancient Near Eastern Studies
Computer Sciences
Cultural Studies
Engineering
General Interest
Geosciences
History
Industrial Chemistry
Jewish Studies
Law
Library and Information Science, Book Studies
Life Sciences
Linguistics and Semiotics
Literary Studies
Materials Sciences
Mathematics
Medicine
Music
Pharmacy
Philosophy
Physics
Social Sciences
Sports and Recreation
Theology and Religion
Publications
Journals
Books
Proceedings
Publishers
Blog
Contact
Search
EUR
USD
GBP
English
English
Deutsch
Polski
Español
Français
Italiano
Cart
Home
Journals
Journal of Ultrasonography
Volume 19 (2019): Issue 76 (March 2019)
Open Access
Isolation of the left subclavian artery in an infant with tetralogy of Fallot, right aortic arch and DiGeorge syndrome. Echocardiographic diagnostic case study
Maciej A. Karolczak
Maciej A. Karolczak
,
Wojciech Mądry
Wojciech Mądry
and
Darren James Grégoire
Darren James Grégoire
| Apr 30, 2019
Journal of Ultrasonography
Volume 19 (2019): Issue 76 (March 2019)
About this article
Previous Article
Next Article
Abstract
Article
Figures & Tables
References
Authors
Articles in this Issue
Preview
PDF
Cite
Share
Article Category:
case-report
Published Online:
Apr 30, 2019
Page range:
66 - 70
Received:
Nov 04, 2018
Accepted:
Jan 22, 2019
DOI:
https://doi.org/10.15557/jou.2019.0010
Keywords
isolated left subclavian artery
,
tetralogy of Fallot
,
DiGeorge syndrome
,
right aortic arch
© 2019 Maciej A. Karolczak et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1.
Preoperative CT angiography. Ao – ascending aorta, PA – pulmonary trunk, LPA – left pulmonary artery, RAo – right aortic arch, DA – ductus arteriosus, LCCA – left common carotid artery, LVA – left vertebral artery
Fig. 2.
Formation of left-sided aortic arch. RaoG – right dorsal aorta, LAoG – left dorsal aorta, LSA – left subclavian artery (the arrow indicates the direction of its migration), LCA – left carotid artery, III and IV – pharyngeal (aortic) arch arteries, DA – ductus arteriosus, AoS – aortic sac, PA – pulmonary trunk (author’s own scheme – M.A.K)
Fig. 3.
Systole. A round cross-section of the ascending aorta (AoAs) filled with red, and the pulmonary trunk (PA) and the right pulmonary artery (RPA) – blue color. A bulge corresponding to the origin of the left common carotid artery (*) is present in the anterior left contour of the ascending aorta (*)
Fig. 4.
A slightly higher cross-section, diastole. The ascending aorta (AoAsc) is not filled with color. Despite the diastolic phase, the pulmonary trunk (PA) and its two branches (RPA and LPA) are filled with intensive blue color – with distinct turbulence. A bulge corresponding to the outlet of the ductus arteriosus (*) is seen in the anterior contour of the pulmonary trunk (PA). The left common carotid artery is not visible during this phase. VBC – the brachiocephalic vein
Fig. 5.
A further shift of ultrasonic beam upwards, systole. Cross-sections of the ascending aorta (Ao) and the left common carotid artery (LCCA), which runs separately at the same level – both vessels are coded in red – as well as the ductus arteriosus (*) and the pulmonary trunk (PA) – these vessels are filled with blue color, indicative of a flow in the opposite direction
Fig. 6.
Even a higher position of the plane of the beam, systole. Cross-sections of the apical portion of the aortic arch (Ao) and the left common carotid artery (LCCA) filled with red color and the ductus arteriosus (*) filled with blue color. A very close proximity of these vessels is noticeable
Fig. 7.
Systole. The ascending aorta (Ao) branching into the left common carotid artery (LCCA) is shown; both vessels are filled with red color and the initial segment of the aortic arch (AAo – blue color)
Fig. 8.
Systole. Further shift of the ultrasound beam to the left side – two close parallel vessels with opposite directions of flow: the left common carotid artery (LCCA) coded in red and the left subclavian artery with ductus arteriosus coded in blue (LSA + PDA)
Fig. 9.
During diastole, the left subclavian artery/ductus arteriosus (PDA+LSA) are more intensely filled, whereas the red color coding for blood flow in the left common carotid artery disappears. Poorly filled with blue color brachiocephalic vein (BCV) is most superficially seen
Fig. 10.
Postoperative assessment. Visible carotid segments of LCCA and LVA. Systole. The direction of the flow in the left vertebral artery is opposite to the flow in the left common carotid artery
Fig. 11.
Recorded flow in the left vertebral artery using pulse Doppler. Systolic flow. Closure of the ductus arteriosus undoubtedly reduced cerebral steal with maintained perfusion in the left upper extremity
Preview