主动脉血管变异，肺动静脉英文课件.ppt

Vascular Anomalies of Aorta, Pulmonary and Systemic vessels Embryology ?Double Arch: ?In the embryo a double arch with two brachiocephalic vessels on each side is present. ?If double aortic arch persists, it forms a vascular ring around trachea and esophagus. ?Normal Left Arch: ?The posterior part of the right arch involutes. ?The two brachiocephalic vessels on the right form the right innominate artery. ?Right Arch with mirror branching: ?Mirror image of normal left arch. ?Posterior part of the left arch involutes. ?The two brachiocephalic vessels on the left form the left innominate artery. ?Left Arch with aberrant right subclavian artery: ?Right arch between the right subclavian and right common carotid artery involutes. ?First branch is the right common carotid, followed by the left carotid and the left subclavian artery. The last branch is the right aberrant subclavian artery. ?Right Arch with aberrant left subclavian artery: ?Mirror image of the left arch with aberrant right subclavian ?First branch is left common carotid, followed by right carotid and right subclavian artery. The last branch is the left aberrant subclavian artery. Aortic Arch Anomalies Right Arch with Aberrant left subclavian The Right Aortic Arch with an aberrant left subclavian is an obstructing arch anomaly. Left Arch Aberrant Right SCA ?Also known as arteria lusoria. ?Most common arch anomaly. ?Not a true ring ?Usually asymptomatic. Below another patient with an aberrant right subclavian. When you follow the artery from inferior to superior, it starts on the left side of the arch and travels obliquely behind the esophagus to go to the right. The diagnosis is the innominate artery compression syndrome. In infants the innominate artery arises more to the left than in adults, so its got to go in front of the trachea. It may compress the trachea, leading to stridor, cough and dyspnea. This compression decreases with age . ?N