scholarly journals Life-Threatening Postpneumonectomy Syndrome Complicated with Right Aortic Arch after Left Pneumonectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Takahiro Karasaki ◽  
Makoto Tanaka
Keyword(s):  
Aortic Arch ◽  
Mycobacterial Infection ◽  
Right Aortic Arch ◽  
Descending Aorta ◽  
Mediastinal Shift ◽  
Right Pulmonary Artery ◽  
Life Threatening ◽  
Nontuberculous Mycobacterial Infection ◽  
Mucosal Edema ◽  
The Right

A 54-year-old man with right aortic arch underwent left lower lobectomy and lingular segmentectomy, followed by complete pneumonectomy, for refractory nontuberculous mycobacterial infection. Three months after the pneumonectomy, he developed acute respiratory distress. Computed tomography showed an excessive mediastinal shift with an extremely narrowed bronchus intermedius and right lower bronchus compressed between the right pulmonary artery and the right descending aorta. Soon after the nearly obstructed bronchus intermedius was observed by bronchoscopy, he began to exhibit frequent hypoxic attacks, perhaps due to mucosal edema. Emergent surgical repositioning of the mediastinum and decompression of the bronchus was indicated. After complete adhesiolysis of the left thoracic cavity was performed, to maintain the proper mediastinal position, considering the emergent setting, an open wound thoracostomy was created and piles of gauze were inserted, mildly compressing the heart and the mediastinum to the right side. Thoracoplasty was performed three months later, and he was eventually discharged without any dressings needed. Mediastinal repositioning under thoracostomy should be avoided in elective cases because of its extremely high invasiveness. However, in the case of life-threatening postpneumonectomy syndrome in an emergent setting, mediastinal repositioning under thoracostomy may be an option to save life, which every thoracic surgeon could attempt.

Utility of Pre- and Postoperative Computed Tomography Angiography for the Evaluation of a Complex Vascular Ring

2019 ◽  
Vol 10 (5) ◽  
pp. 654-656
Author(s):  
Philip B. Dydynski ◽  
John S. Austin ◽  
Deborah Kozik ◽  
Bahaaldin Alsoufi
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Computed Tomography Angiography ◽  
Vascular Ring ◽  
Left Pulmonary Artery ◽  
Aberrant Right Subclavian Artery ◽  
Descending Aorta ◽  
Right Pulmonary Artery ◽  
The Right

We present the case of a neonate born with an unusual complex vascular ring formed by a left-sided aortic arch that had retroesophageal course to join a right-sided descending aorta and a very large right-sided arterial ductus from the right pulmonary artery to the descending aorta. Associated finings included aortic arch hypoplasia, aberrant right subclavian artery, and aberrant origin of the left pulmonary artery from the aorta. We focus on the role of computed tomography angiography in the preoperative and postoperative assessment of this complex anomaly.

Pathogenesis of solitary right aortic arch: a mass effect hypothesis based on observations of serial human embryonic sections

2015 ◽  
Vol 27 (2) ◽  
pp. 359-368
Author(s):  
Zhe W. Jin ◽  
Tomonori Yamada ◽  
Ji H. Kim ◽  
José F. Rodríguez-Vázquez ◽  
Gen Murakami ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Aortic Arch ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Mass Effect ◽  
Left Pulmonary Artery ◽  
Sympathetic Ganglia ◽  
Right Aortic Arch ◽  
Descending Aorta ◽  
The Right

AbstractIn general, solitary right aortic arch carries the left-sided ductus arteriosus communicating between the left subclavian and pulmonary arteries or the right-sided ductus connecting the descending aorta to the left pulmonary artery. Serial sections of fifteen 5- to 6-week-old embryos and ten 8- to 9-week-old fetuses suggested that the pathogenesis was unrelated to inversion due to dysfunction in gene cascades that control the systemic left/right axis. With inversion, conversely, the ductus or the sixth pharyngeal arch artery should connect to the right pulmonary artery. The disappearance of the right aortic arch started before the caudal migration of the aortic attachment of the ductus. Sympathetic nerve ganglia developed immediately posterior to both aortae, with a single embryonic specimen showing a large ganglion at the midline close to the union of the aortic arches. These ganglia may interfere with blood flow through the distal left arch, resulting in the ductus ending at the descending aorta behind the oesophagus. In another fetus examined, a midline shift of the ductus course resulted in the trachea curving posteriorly. Therefore, solitary right arch is likely to accompany abnormalities of the surrounding structures. The timing and site of the obstruction should be different between types: an almost midline obstruction near the aortic union needed for the development of the left-sided ductus and a distal obstruction near the left subclavian arterial origin needed for the development of the right-sided ductus. A mass effect of the sympathetic ganglia may explain the pathogenesis of any type of anomalous ductus arteriosus shown in previous reports of the solitary right arch.

scholarly journals Barium sulphate aspiration pneumonia in a cat with megaesophagus and dextroposition of the aortic arch: case report

2018 ◽  
Vol 70 (5) ◽  
pp. 1453-1458
Author(s):  
J.A. Barrera-Zarate ◽  
B.A. Paiva ◽  
D.P. Ferreira ◽  
F.S. Alves ◽  
J.P.H. Sato ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aspiration Pneumonia ◽  
Barium Sulfate ◽  
Polarized Light ◽  
Barium Sulphate ◽  
Right Aortic Arch ◽  
Thoracic Esophagus ◽  
Severe Respiratory Distress ◽  
The Right ◽  
Histiocytic Infiltration

ABSTRACT A six-month-old female cat suffered aspiration of an abundant amount of barium sulfate during a radiographic procedure for the diagnosis of megaesophagus. Latero-lateral contrast radiography revealed severe dilation of the thoracic esophagus cranial to the base of the heart. Persistence of the right aortic arch was suspected and later confirmed during corrective surgery. Accumulation of barium sulfate, used as a contrast agent, was clearly observed in the lumen of the bronchi, bronchioles, and alveoli in the radiographic image. Days after the surgery, the animal developed severe respiratory distress, which resulted in death. Cytology results and histology analysis using polarized light demonstrated that the lumen of bronchi, bronchioles, and alveoli exhibited evident histiocytic infiltration with cytoplasm filled by abundant amorphous refractive granular material consistent with barium sulfate. In this report, we describe the anatomical, cytological, histopathological (using polarized light), and x-ray findings of a case of barium sulfate aspiration pneumonia in a cat resulting from the use of this contrast medium for the diagnosis of megaesophagus secondary to persistent right aortic arch.

DOUBLE AORTIC ARCH

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 751-768
Author(s):  
HERBERT E. GRISWOLD ◽  
MAURICE D. YOUNG
Keyword(s):  
Aortic Arch ◽  
Double Aortic Arch ◽  
Rare Type ◽  
Radiographic Findings ◽  
Descending Aorta ◽  
Vascular Abnormalities ◽  
History Of ◽  
The Right ◽  
The Given ◽  
Right Descending Aorta

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed. Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch. Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that: 1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic. 2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms. 3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component. 4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta. 5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare. The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.

scholarly journals Right aortic arch with an aberrant left subclavian artery: sonographic features by HDlive Flow imaging

2020 ◽  
Vol 30 (6) ◽  
pp. 892-893
Author(s):  
Toyohide Endo ◽  
Daigo Ochiai ◽  
Mamoru Tanaka
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Vascular Ring ◽  
Vascular Anomaly ◽  
Right Aortic Arch ◽  
Flow Imaging ◽  
Branching Pattern ◽  
Aberrant Left Subclavian Artery ◽  
The Right

AbstractThe right aortic arch is a congenital vascular anomaly, which may form a vascular ring. However, prenatal identification of the branching pattern of brachiocephalic vessels is often limited. In this paper, we clearly demonstrated the branching pattern of brachiocephalic vessels in a case of right aortic arch with an aberrant left subclavian artery using HDlive Flow imaging.

Surgical Management of Right Aortic Arch Obstruction Associated With Rare Form of Vascular Ring

2020 ◽  
Vol 11 (2) ◽  
pp. 222-225
Author(s):  
Evgeny V. Krivoshchekov ◽  
Frank Cetta ◽  
Oleg A. Egunov ◽  
Evgenii A. Sviazov ◽  
Valeriy O. Kiselev ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Management ◽  
Rare Case ◽  
Vascular Ring ◽  
Right Aortic Arch ◽  
Rare Form ◽  
Descending Aorta ◽  
Arch Obstruction ◽  
Right Descending Aorta

This clinical case demonstrated surgical management for a rare case of vascular ring associated with an elongated and kinked aortic arch and a right descending aorta in a ten-year-old male using an extra-anatomic bypass grafting method and dividing the vascular ring. Computer tomography performed at six-month follow-up showed a favorable surgical outcome.

scholarly journals Stent erosion after treatment of coarctation of right-sided aorta and successful surgical management

2019 ◽  
Vol 57 (5) ◽  
pp. 1007-1008
Author(s):  
Andreas Rukosujew ◽  
Raluca Weber ◽  
Bernd Kasprzak ◽  
Angelo Maria Dell’Aquila
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Septal Defect ◽  
Artery Bypass ◽  
Previous History ◽  
Second Step ◽  
Descending Aorta ◽  
History Of ◽  
Aorta Replacement ◽  
The Right

Abstract We present a case of surgical treatment of a pseudoaneurysm of the right-sided aortic arch after stent implantation for primary coarctation in a 36-year-old woman with a previous history of ventricle septal defect closure in early childhood. As a first step, she underwent a left carotid to subclavian artery bypass for an aberrant left subclavian artery and as a second step a ‘beating heart’ aortic arch and descending aorta replacement via resternotomy. The postoperative course was uneventful.

scholarly journals Swing-back and trap-door technique repair for interrupted aortic arch with right-sided descending aorta

2019 ◽  
Vol 29 (5) ◽  
pp. 818-819
Author(s):  
Shuichi Shiraishi ◽  
Ai Sugimoto ◽  
Masanori Tsuchida
Keyword(s):  
Congenital Anomaly ◽  
Aortic Arch ◽  
Surgical Repair ◽  
Interrupted Aortic Arch ◽  
Thoracic Cavity ◽  
Descending Aorta ◽  
Rare Congenital Anomaly ◽  
Trap Door ◽  
Oesophageal Obstruction ◽  
The Right

Abstract A right-sided descending aorta with a left aortic arch is a rare congenital anomaly in which the aortic arch crosses the midline from the left side of the trachea coursing to the descending aorta in the right thoracic cavity. The surgical repair of an interrupted aortic arch with a right-sided descending aorta carries great risks of bronchial and oesophageal obstruction. Herein, we describe a case of successful surgical repair of an interrupted aortic arch with a right-sided descending aorta using the swing-back and trap-door techniques.

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