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Anomalous Origin of the Innominate Artery

Tracheo-Innominate Artery Fistula


Presentation

  • One was a 15-month-old boy presenting with respiratory distress. He had a right aortic arch and his left pulmonary artery originated from the innominate artery. The other was a 1-month-old girl presenting with congestive heart failure.[ncbi.nlm.nih.gov]
  • The time is definitely right for a comprehensive presentation of these new diagnostic modalities and the way in which they will influence the field of congenital heart management. * First and only volume on the market presenting all the pre- and post-operative[books.google.com]
Pain
  • Copyright & Usage: American College of Cardiology Foundation Yang Min Kim , MD ⁎ , Rak Kyeong Choi , MD † and Chang Keun Lee , MD ⁎ ⁎ † A 78-year-old woman was admitted with chest pain. Coronary angiography revealed a normal right coronary artery.[onlinejacc.org]
  • 36.00Published by Elsevier Inc. doi:10.1016/j.jacc.2009.02.070m the Departments ofdiology and Internaldicine, Sejong HospitalSejong Heart Institute,nggi, South Korea.nuscript receivedary 21, 2009;pted February 6, 2009.A78-year-old woman was admitted with chest pain[documents.tips]
  • Key Words anomalous origin innominate artery left main A 73-year-old woman was admitted with progressive chest pain for 2 years. She had a history of hypertension for 9 years. Findings on physical examination were normal.[interventions.onlinejacc.org]
  • Patient 3 A 44-year-old man was emergently admitted for intractable chest pain. He had suffered from intermittent chest pain for several months. Echocardiogram revealed hypokinesia in the territory of the RCA.[cardiothoracicsurgery.biomedcentral.com]
  • Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria, although this is a rare complication. [2] [3] In addition to dysphagia, aberrant right subclavian artery may cause stridor, dyspnoea, chest pain, or fever. [1] An aberrant[en.wikipedia.org]
Congestive Heart Failure
  • The other was a 1-month-old girl presenting with congestive heart failure. She had a left aortic arch and her right pulmonary artery originated from the innominate artery.[ncbi.nlm.nih.gov]
  • She had no respiratory symptoms such as stridor or wheezing, and there were no signs or symptoms of congestive heart failure.[scmr.org]
  • Diagnosis and Management The clinical presentation of anomalous origin of a pulmonary artery branch from the ascending aorta is predominantly that of congestive heart failure in infancy followed by the development of pulmonary vascular disease as early[quizlet.com]
Pathologist
  • All clinicians and scientists interested in birth defects, including pediatricians, geneticists, genetic counselors, obstetricians, and pediatric pathologists, will find this book to be an invaluable source of information.[books.google.com]
  • Department of Radiodiagnosis, Government Medical College and Associated Group of Hospitals, Kota - 324 001, Rajasthan India DOI : 10.4103/1115-1474.134615 The aberrant right subclavian artery (ARSA) is an anatomical abnormality encountered by anatomists and pathologists[wajradiology.org]
Fatigue
  • Patients can later present with hypovolemic shock which include symptoms of tachycardia , cyanosis , cold and clammy skin, dizziness, confusion, and fatigue. [3] [5] Patients may also develop septicemia . [3] [5] Treatment [ edit ] Prevention [ edit ][en.wikipedia.org]
  • As her complaints were continually aggravated, rather than diminished by time, she became at length unable to struggle; and being worn out with fatigue and famine (for it is asserted that she scarcely swallowed a single morsel for the last three weeks[anatomyatlases.org]
Multiple Organ Dysfunction Syndrome
Stridor
  • Vascular rings diagnosed in patients less than 6 months of age are often associated with symptoms of airway obstruction, such as stridor (noisy breathing).[cincinnatichildrens.org]
  • Usually, patients with a double aortic arch are severely symptomatic in infancy, with stridor, dyspnea, cough, and recurrent respiratory infections.[musculoskeletalkey.com]
  • It may compress the trachea, leading to stridor, cough and dyspnea. This compression decreases with age and these patients will outgrow it.[radiologyassistant.nl]
  • Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria, although this is a rare complication. [2] [3] In addition to dysphagia, aberrant right subclavian artery may cause stridor, dyspnoea, chest pain, or fever. [1] An aberrant[en.wikipedia.org]
  • She had no respiratory symptoms such as stridor or wheezing, and there were no signs or symptoms of congestive heart failure.[scmr.org]
Respiratory Distress
  • One was a 15-month-old boy presenting with respiratory distress. He had a right aortic arch and his left pulmonary artery originated from the innominate artery. The other was a 1-month-old girl presenting with congestive heart failure.[ncbi.nlm.nih.gov]
  • Infants feed poorly because of severe respiratory distress and may prefer to assume an opisthotonic posture. Life-threatening episodes of apnea with cyanosis may occur.[musculoskeletalkey.com]
  • Increased respiratory distress a/w intercurrent respiratory infections. Swallowing difficulty .[slideshare.net]
  • Although, in some cases, spontaneous improvement can occur, TM can also result in severe cough, respiratory distress episodes or “near-death” spells (acute life-threatening events, ALTE).[ijponline.biomedcentral.com]
Choking
  • Choking or swallowing difficulties are more common in older children as the predominant symptoms. Occasionally, a vascular ring is discovered incidentally during evaluation of a seemingly unrelated problem.[cincinnatichildrens.org]
  • .  Symptoms- Stridor,Pneumonia,bronchitis Reflex apnoea or choking on eating. Posture of Hyperextension of neck in infant. Increased respiratory distress a/w intercurrent respiratory infections. Swallowing difficulty .[slideshare.net]
  • Less commonly and usually in toddlers or older children, the presentation will be swallowing difficulty or choking on food.[quizlet.com]
Chest Pain
  • Copyright & Usage: American College of Cardiology Foundation Yang Min Kim , MD ⁎ , Rak Kyeong Choi , MD † and Chang Keun Lee , MD ⁎ ⁎ † A 78-year-old woman was admitted with chest pain. Coronary angiography revealed a normal right coronary artery.[onlinejacc.org]
  • Key Words anomalous origin innominate artery left main A 73-year-old woman was admitted with progressive chest pain for 2 years. She had a history of hypertension for 9 years. Findings on physical examination were normal.[interventions.onlinejacc.org]
  • Patient 3 A 44-year-old man was emergently admitted for intractable chest pain. He had suffered from intermittent chest pain for several months. Echocardiogram revealed hypokinesia in the territory of the RCA.[cardiothoracicsurgery.biomedcentral.com]
  • Dysphagia due to an aberrant right subclavian artery is termed dysphagia lusoria, although this is a rare complication. [2] [3] In addition to dysphagia, aberrant right subclavian artery may cause stridor, dyspnoea, chest pain, or fever. [1] An aberrant[en.wikipedia.org]
Heart Failure
  • The other was a 1-month-old girl presenting with congestive heart failure. She had a left aortic arch and her right pulmonary artery originated from the innominate artery.[ncbi.nlm.nih.gov]
  • She had no respiratory symptoms such as stridor or wheezing, and there were no signs or symptoms of congestive heart failure.[scmr.org]
  • Associated with bicuspid aortic valve (75%), cerebral aneurysms (5-10%) and Turner syndrome (20% have coarctation) On the left a 2 month old boy with heart failure.[radiologyassistant.nl]
  • .  Present with acute cardiovascular collapse or heart failure after closure of ductus in first days of life.  Absence of all limb pulse with strong carotid pulse suggest type B with anomalous subclavian.  2 D echo is most important diagnostic tool[slideshare.net]
Hypertension
  • Percutaneous angioplasty in clinical management of renovascular hypertension: initial and long-term results. ‏ الصفحة 65 - Henry M. Amor M, Ethevenot G, et al.[books.google.com]
  • She had a history of hypertension for 9 years. Findings on physical examination were normal. Low-density lipoprotein cholesterol level was 3.04 mmol/l. Results on electrocardiography and echocardiography were normal.[interventions.onlinejacc.org]
  • Diagnosis and differential assessment of pulmonary arterial hypertension . J Am Coll Cardiol 2004 ; 43 : 40 – 47 . 2. Steinhorn , RH . Neonatal pulmonary hypertension . Pediatr Crit Care Med 2010 ; 11 : 79 – 84 . 3. Delaney , C , Cornfield , DN .[cambridge.org]
  • Associated vascular disease and hypertension were common. There was no mortality and few complications. Axillo-axillary bypass grafting is considered the operation of choice for patients with subclavian steal syndrome. ( Arch Surg 114:394-399, 1979)[jamanetwork.com]
  • When there is a significant shunt, they may cause (late) pulmonary hypertension as seen in the case on the left.[radiologyassistant.nl]
Vascular Disease
  • You are more likely to have vascular disease as you get older.[icdlist.com]
  • Associated vascular disease and hypertension were common. There was no mortality and few complications. Axillo-axillary bypass grafting is considered the operation of choice for patients with subclavian steal syndrome. ( Arch Surg 114:394-399, 1979)[jamanetwork.com]
  • disease. 57.  LPA arises from RPA and passes b/w trachea and esophagus-Pulmonary artery sling.  Only Anomaly in which a major vascular structure passes between trachea and esophagus.  Tracheal compression-Severe respiratory distress and stridor,Milder[slideshare.net]
  • This should be carried out as early as possible to avoid the development of pulmonary vascular disease.[quizlet.com]
Encephalopathy
  • Keep current with the latest developments in palliative care, mass casualty/epidemic disease, acute respiratory failure, non-invasive ventilation, neurocritical care, neuroimaging, hypoxic-ischemic encephalopathy, stroke and intracerebral hemorrhage,[books.google.com]

Treatment

  • Emphasizes the treatment of corrected congenital heart disease for coverage of the clinical management of cardiac problems in the adolescent and young adult.[books.google.com]
  • Other treatments include medicines and surgery.[icdlist.com]

Prognosis

  • […] bleeding, seal the mediastinum , fill dead space, cover major vital structures, provide a blood supply and venous drainage, and increase the concentration of antibiotics. [3] [4] Innominate artery ligation has a 10% risk of neurological deficit. [2] Prognosis[en.wikipedia.org]
  • The location and extent of the dissection has important implications for treatment and prognosis. The DeBakey and Stanford classifications are illustrated in Figure 6-10.[radiologykey.com]
  • View Article PubMed Google Scholar Kaku B, Shimizu M, Yoshio H, Ino H, Mizuno S, Kanaya H, Ishise S, Mabuchi H: Clinical features and prognosis of japanese patients with anomalous origin of the coronary artery.[cardiothoracicsurgery.biomedcentral.com]

Etiology

  • This book serves these needs well through a nicely balanced focus on prevention, on the one hand, with its comprehensive review of epidemiology and etiology, and on management, on the other, with its practical comments on diagnosis, treatment and outcome[books.google.it]
  • Dissection (online cases 13 and 52) Etiology A dissection is a longitudinal split in the media of the aortic wall. In most cases, an intimal tear connects this medial channel with the aortic lumen.[radiologykey.com]
  • Embryology [Print Section] The etiology of interrupted aortic arches can be thought of in terms similar to those that describe the formation of the other arch anomalies discussed above.[quizlet.com]
  • McKissock. (1934-35) The etiology of the vascular symptoms of cervical rib. Br. J. Surg. 22:406-414. Blalock, A. (1947) Technique of creation of an artificial ductus arteriosus in the treatment of pulmonary stenosis. J. Thoracic Surgery 16:244-254.[anatomyatlases.org]

Epidemiology

  • The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly.[books.google.com]
  • This book serves these needs well through a nicely balanced focus on prevention, on the one hand, with its comprehensive review of epidemiology and etiology, and on management, on the other, with its practical comments on diagnosis, treatment and outcome[books.google.it]
  • Research output : Contribution to journal › Article Epidemiology of invasive fungal diseases in children with solid tumours undergoing autologous haematopoietic stem cell transplantation: a 10-year experience in a tertiary Italian centre Tatarelli, P.[moh-it.pure.elsevier.com]
Sex distribution
Age distribution

Pathophysiology

  • […] the proximal descending aorta, the so-called Diverticulum of Kommerell (which was named for the German Radiologist, Burkhard Friedrich Kommerell (1901–1990), who discovered it in 1936). [5] [6] It is alternatively known as a lusorian artery. [1] [3] Pathophysiology[en.wikipedia.org]
  • Ultimately, it is important to understand the pathophysiology of AOCA treatment to manage this condition effectively.[cardiothoracicsurgery.biomedcentral.com]
  • The pathophysiology of the interruption is thought to be an absolute decrease in left ventricular output to the ascending aorta (owing to the combination of outflow obstruction and VSD) with maintenance of normal cerebral perfusion, resulting in a P.755[quizlet.com]

Prevention

  • The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly.[books.google.com]
  • Even were it not for medical-legal liability, the importance of prompt recognition and correct treatment of injuries that we ourselves cause is obvious, as is the need for preventive measures to be clearly identified and adopted.[books.google.it]
  • Patients can later present with hypovolemic shock which include symptoms of tachycardia , cyanosis , cold and clammy skin, dizziness, confusion, and fatigue. [3] [5] Patients may also develop septicemia . [3] [5] Treatment [ edit ] Prevention [ edit ][en.wikipedia.org]
  • Centers for Disease Control and Prevention Intersex (Medical Encyclopedia) [ Read More ] Vascular Diseases The vascular system is the body's network of blood vessels.[icdlist.com]
  • Non-visualization This means that there is an absence of a normal artery because it did not form, or it is not seen on an MRI/MRA because blockage prevents the flow of contrast through the vessel.[chw.org]

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