Aortic Arch Abnormalities
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1 Aortic Arch Abnormalities IPOK Norman H Silverman MD, D Sc (Med.). FACC, FAHA. Stanford University & Lucile Packard Children s Hospital E mail: norm.silverman@stanford.edu. NHS.
2 Abnormalities Supravalvar Aortic Stenosis The Aortic Root in Marfan s Syndrome Interruption Hypoplasia High Aortic Arch Arch Laterality Coarctation Vascular Rings
3 Examination Technique A variety views should be used including :- Suprasternal coronal and sagittal imaging, Parasternal and Subcostal views of the aorta and its relations. The Imaging should be complemented by various Doppler modalities including Color flow imaging.
4 Normal Aortic Arch Echo
5 Normal Aortic Arch SSN Sagittal AAo IV RBr RPA D Ao
6 Aortic Arch Laterality Transducer alignment The arch direction follows the plane of the array Innominate Artery The innominate artery always bifurcates on the opposite side to the aortic arch. Lack of bifurcation may indicate that there is an anomalous subclavian artery Tracheal Rings or Esophagus The descending aorta can be recognized by the examiner either to the left (in left aortic arch) or to the right (in right aortic arch)
7 Innominate Artery Shows Arch Position Right Innominate, therefore left arch Left innominate, therefore right arch NHS.
8 Arch Laterality R Arch A Trachea A Left Arch
9 Tracheal Rings
10 Arch Laterality Left Arch Right Arch
11 Routine Arch Sweep
12 Normal Aorta: Color Imaging IV THYMUS TAO LCA AAo LSA LA RPA DAo
13 Supravalvar Aortic Stenosis
14 Supravalvar Aortic Stenosis
15 William s Syndrome
16 William s Syndrome
17 Supravalvar Aortic Stenosis RV LV Ao LA L Ax
18 Supravalvar Aortic Stenosis Ao RV LV Subcost. Coronal Ao P L Ax
19 Bicuspid Aortic Valve & Multiple Dissections
20 Aortic Dissection, Coarctation & Bicuspid Aortic Valve
21 Bicuspid Aortic Valve: Post Stenotic Dilatation AAo AAo LV
22 Marfan s Syndrome
23 Marfan s Syndrome Mariska Kemna
24 Marfan s Syndrome: Dilated Aortic Root RV P Sax. Ao RA LA DAo LX LA RV LA Ao
25 Marfan s Syndrome: Dilated Aortic Root Aortic Regurgitation
26 Marfan s Syndrome: Dilated Aortic Root
27 Marfan s Syndrome: Dilated Aortic Root
28 Coarctation
29 Coarctation Courtesy Diane Spicer
30 Coarctation
31 NHS. Pathological Varieties of Coarctation &Techniques of Display
32 DUCTUS SLING IN COARCTATION
33 Doppler of Coarctation
34 Coarctation A Ao Duct Beak PA Shelf DAo
35 Color Angiogram in Coarctation Tr Ao Arch Innominate Artery RPA L Subclavian Coarctation DAO NHS.
36 HYPOPLASTIC ISTHMUS
37 Ductus &? Coarctation: On Prostaglandin MPA Duct Isthmus LA LPA DAo? Coarct NHS.
38 Coarctation of the Aorta PA TAO DAO OFF PGE1 On PGE1 NHS.
39 Taussig- Bing Malformation and Coarctation IV TAO AAo PA Coarct LA D Ao
40 The Diversity of Coarctation
41 Coarctation-MRI 3 D Reconstruction Courtesy of Dr. Keren Hasbani
42 Coarctation: End - to - Side Anastomosis SSN Cor. IV PA Suture Line D Ao
43 Fifth Aortic Arch
44 PMW 07
45 Interrupted Aortic Arch: Associations Ventricular septal defect Catch 22 Syndrome Truncus arteriosus Aortopulmonary Window Taussig Bing Malformation
46 Aortic Arch Interruption Found with:- 22 Q- Truncus Arteriosus Taussig Bing Aortopulmonary Window VSD C B A
47 Aortic Arch Interruption
48 Type B Interruption AAo LSA PA D
49 Type B Interruption: Ductus & Descending Aorta MPA AAo LSA LA D A O Duct
50 Interrupted Aortic Arch Sagittal Plane Imaging MPA R L D LA D A O NHS.
51 INTERRUPTED ARCH TYPE B In. Vn In. A LSA AAo Duct D Ao
52 Interrupted Arch: 2 Different Doppler Signals a NHS.
53 Truncus with Interrupted Aortic Arch D A Ao LPA Tr RV * LV
54 The VSD in Interruption & Coarctation A4Ch. Ao P Lx RV LV RV LV Ao In Coarctation and interruption of the aortic arch, all the woe, lies below! Richard Van Praagh. LA
55 Arch Embryology
56 Arch Embryology
57 Right Aortic Arch Left Arch: Cervical Arch and Right Ductus
58 High ( Cervical ) Arch Right PA
59 Right PA High ( Cervical ) Arch
60 RAA- LPDA ALSCA DAA
61 Bronchoscopy RT Mainstem Bronchus Compression LT RT
62
63 Coronal Scan
64 Double Aortic Arch R L AAO
65 Double Aortic Arch
66 Fetal Double Aortic Arch
67 Double Aortic Arch
68 L Duct, Right Ao Arch
69 Interrupted Aortic Arch, R Desc. Ao & R Duct- Another Bronchial Vise
70 Right Arch with Aberrant Left Subclavian Left subclavian Left ductus Diverticulum of Kommerell's RING CP
71 Right Arch Mirror-image Branching and No Ring Right Arch Mirror Image Branching Left ductus From innominate NO RING CP
72 Right Aortic Arch Aberrant L subclavian artery and L arterial duct
73 Left Aortic Arch with Aberrant Right Subclavian Aberrant RT SCA CP
74 Left Duct with Right Aortic Arch
75 Resection of Kommerell s diverticulum and left subclavian artery transfer for recurrent symptoms after vascular ring division C.L. Backer, N. Hillman, C. Mavroudis, L.D. Holinger EJCTS Reoperations 7 Primary operations
76 Kommerell s Diverticulum
77 Kommerell s Diverticulum Aortic diverticulum
78 Left Ductus: Right Arch Potentially Isolated L subclav. Art NHS.
79 BILATERAL DUCTS WITH ABSENT CENTRAL PA S
80 Bilateral Ductus
81 Bilateral Ducts & Absent Central PA s Left Innominate and Duct Right Arch and Duct
82 MAPCA s LA D A O S Cost Sagittal S Sost Coronal P Sx
83 Pulmonary Artery Sling Front Back
84 CT Bronchial Tomography
85 Pulmonary artery Sling ECHO LPA
86 PA Sling
87 Pulmonary Artery Sling RPA LPA
88 Pulmonary Artery Sling PSX AO MPA RPA AO MPA LPA RPA LPA
89 Thank You!
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