Presentation
Preterm infant, post cesarian section. Prenatal ultrasound revealed congenital cardiovascular anomalies.
Patient Data
Discontinuity of the aortic arch; the ascending aorta originates from the left ventricular outflow system while the descending aorta originates from the main pulmonary trunk with a narrow segment at its origin (patent ductus arteriosus - PDA).
Evidence of both atrial and ventricular septal defect (ASD & VSD).
Both common carotid arteries and the right subclavian artery originate from a common trunk (brachiocephalic artery).
The left subclavian artery originated from the descending aorta.
Increased cardiothoracic ratio with congestive and atelectatic lung changes.
Dilated main pulmonary trunk, no evidence of thrombosis.
Abdominal images show significant amount of free fluid.
Umbilical catheter and nasogastric tube are noted.
Case Discussion
The patient underwent echocardiography soon after birth and was found to have large ASD with left to right shunt, large subaortic VSD with signs of severe pulmonary hypertension and small PDA.
Then, she started on prostaglandin E and was referred for surgical correction.
Interrupted aortic arch - type B occurs when an interruption between the left carotid artery and the left subclavian artery is established. It is the most common interrupted aortic arch and accounts for about half of reported cases.