主动脉血管变异，肺动静脉英文课件.ppt

Vascular Anomalies of Aorta, Pulmonary and Systemic vessels;Overview of Arch Anomalies;Embryology;?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;This anomaly is asymptomatic, because there is no obstructing ring. Almost all of these patients however come to our attention because they have associated congenital heart disease in 98% of cases. This patient had a mirror image aortic arch and a VSD. ;above an adult who was operated in his childhood for a Tetralogy of Fallot (pulmonary stenosis, right ventricular hypertrophy, VSD, overriding aorta). At surgery the VSD was patched and the pulmonary outflow tract was enlarged. Notice that there is also a right arch.;Right Arch with Aberrant left subclavian;Below a patient with a right arch with an aberrant left subclavian (indicated by the yellow arrow). The yellow arrow indicates the azygos vein.? The green arrow indicates the left superior intercostal vein, a normal variant, that we will discuss later.;Posterior oblique view: Right Arch with Aberrant left subclavian (yellow arrow);Below a symptomatic child.On the ax