A Rare Anatomic Variation: A Combination of Anomalous Origin of the Right Subclavian Artery from the Main Pulmonary Artery, Ventricular Septal Defect, and Aortic Coarctation

Authors

  • Can Vuran
  • Oguz Omay
  • Canan Ayabakan
  • Ozgen Ilgaz Kocyigit
  • Uygar Yoruker
  • Riza Turkoz

DOI:

https://doi.org/10.1532/HSF98.20091172

Abstract

Background: We present a rare case of an anomalous origin of the right subclavian artery (SA) from the pulmonary artery (PA) associated with ventricular septal defect (VSD) and aortic coarctation.

Case Report: Critical aortic coarctation and VSD were diagnosed in a neonate, and coarctation angioplasty was successfully performed. Severe cardiac failure developed after this procedure, however, and closure of the VSD was planned.

Results: The anomalous SA was diagnosed during the operation when the cardiopulmonary bypass was initiated. As the pulmonary blood flow decreased, a difference in pulse pressures between the right radial artery and the ascending aorta was noticed to be due to the subclavian steal phenomenon. The difference decreased from 60 mm Hg to 25 mm Hg following ligation of the SA at its origin from the PA. The patient was discharged on the eighth postoperative day without any problems.

Conclusion: An abnormal origin of the right SA from the main PA associated with VSD and aortic coarctation is a unique combination that, if unnoticed preoperatively, may create difficulties during the operation.

References

Baudet E, Roques XF, Guibaud JP, Laborde N, Choussat A. 1992. Isolation of the right subclavian artery. Ann Thorac Surg 53:501-3.nHofbeck M, Rupprecht T, Reif R, Singer H. 1991. Faulty origin of the right subclavian artery from the pulmonary artery: a rare cause of subclavian steal syndrome in childhood [in German]. Monatsschr Kinderheilkd 139:363-5.nMarin C, Sanchez ML, Fernandez-Velilla M, Ruiz Y, Maroto E, Delgado J. 2008. MR imaging of isolated right subclavian artery. Pediatr Radiol 38:216-9.nMcElhinney DB, Silverman NH, Brook MM, Reddy VM, Hanley FL. 1998. Rare forms of isolation of the subclavian artery: echocardiographic diagnosis and surgical considerations. Cardiol Young 8:344-51.nMosieri J, Chintala K, Delius RE, Walters HL 3rd, Hakimi M. 2004. Abnormal origin of the right subclavian artery from the right pulmonary artery in a patient with D-transposition of the great vessels and left juxtaposition of the right atrial appendage. J Card Surg 19:41-4.nMulay AV, Watterson KG. 1997. Isolated right subclavian artery, interrupted aortic arch, and ventricular septal defect. Ann Thorac Surg 63:1163-5.nStewart JA, Kincaid OW, Edwards JE. 1963. An atlas of vascular rings and related malformations of the aortic arch system. Springfeld, Ill: Charles C Thomas.n

Published

2010-06-09

How to Cite

Vuran, C., Omay, O., Ayabakan, C., Kocyigit, O. I., Yoruker, U., & Turkoz, R. (2010). A Rare Anatomic Variation: A Combination of Anomalous Origin of the Right Subclavian Artery from the Main Pulmonary Artery, Ventricular Septal Defect, and Aortic Coarctation. The Heart Surgery Forum, 13(3), E202-E204. https://doi.org/10.1532/HSF98.20091172

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