{"id":241,"date":"2018-02-06T20:36:03","date_gmt":"2018-02-06T20:36:03","guid":{"rendered":"https:\/\/wp.uthscsa.edu\/ct-surgery\/?page_id=241"},"modified":"2020-07-31T18:31:27","modified_gmt":"2020-07-31T18:31:27","slug":"interrupted-aortic-arch-iaa","status":"publish","type":"page","link":"https:\/\/lsom.uthscsa.edu\/ct-surgery\/patient-care\/congenital-heart\/conditions-we-treat\/interrupted-aortic-arch-iaa\/","title":{"rendered":"Interrupted Aortic Arch (IAA)"},"content":{"rendered":"<p>In interrupted aortic arch, there is an absence of luminal continuity between the ascending aorta and the descending aorta.\u00a0 There are three types of IAA, and each describes where the interruption takes place. Most common type is B, where the defect lies between the left carotid and left subclavian artery. There is almost always a large VSD.\u00a0\u00a0 An aberrant right subclavian artery arising from the descending thoracic aorta and passing posterior to the esophagus is common, especially in type B.\u00a0 Blood reaches the descending aorta via the ductus arteriosus (PGE-1 dependent).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-242 aligncenter\" src=\"https:\/\/lsom.uthscsa.edu\/ct-surgery\/wp-content\/uploads\/sites\/32\/2018\/02\/families-iaa.jpg\" alt=\"\" width=\"433\" height=\"95\" srcset=\"https:\/\/lsom.uthscsa.edu\/ct-surgery\/wp-content\/uploads\/sites\/32\/2018\/02\/families-iaa.jpg 433w, https:\/\/lsom.uthscsa.edu\/ct-surgery\/wp-content\/uploads\/sites\/32\/2018\/02\/families-iaa-300x66.jpg 300w\" sizes=\"auto, (max-width: 433px) 100vw, 433px\" \/>Patients present within the first 2 weeks of life.\u00a0 As PVR decreases and pulmonary blood flow increases, patients develop signs of congestive heart failure, and these worsen as the ductus begins to close.\u00a0 The lower extremities may also become mottled or gray.\u00a0 There is eventually circulatory collapse and profound shock.\u00a0 PGE1 should be infused to maintain ductal patency.\u00a0 Hyperventilation should be avoided so as to not increase pulmonary blood flow and further worsen systemic perfusion.\u00a0 Echocardiography is used for diagnosis and can identify the site of the interruption as well as an anomalous right subclavian artery and any associated cardiac defects, including the VSD.\u00a0 DiGeorge syndrome is present about 27% of the time and may be indicated by hypocalcemia.<\/p>\n<p>Repair is accomplished through a median sternotomy, and the arch may be reconstructed under deep hypothermic circulatory arrest, using a piece of homograft for augmentation if necessary.\u00a0 The PDA and the VSD are both closed in the same procedure.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In interrupted aortic arch, there is an absence of luminal continuity between the ascending aorta and the descending aorta.\u00a0 There are three types of IAA, and each describes where the interruption takes place. Most common type is B, where the defect lies between the left carotid and left subclavian artery. There is almost always a [&hellip;]<\/p>\n","protected":false},"author":161,"featured_media":0,"parent":1337,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-241","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Interrupted Aortic Arch (IAA) - Cardiothoracic Surgery<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lsom.uthscsa.edu\/ct-surgery\/patient-care\/congenital-heart\/conditions-we-treat\/interrupted-aortic-arch-iaa\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Interrupted Aortic Arch (IAA) - Cardiothoracic Surgery\" \/>\n<meta property=\"og:description\" content=\"In interrupted aortic arch, there is an absence of luminal continuity between the ascending aorta and the descending aorta.\u00a0 There are three types of IAA, and each describes where the interruption takes place. 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