Persistent fifth aortic arch
Authors:
Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
3 National Medical Research Center for Children’s Health, Moscow, Russian Federation
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Type: Reviews
DOI:
For citation: Malozemova O.G., Gasanova R.M., Yarygina T.A., Kholmanskaya E.V., Turko Kh.R. Persistent fifth aortic arch. Creative Cardiology. 2023; 17 (2): 227–36 (in Russ.). DOI: 10.24022/1997-3187-2023-17-2-227-236
Received / Accepted: 05.05.2023 / 20.06.2023
Keywords: persistent fifth aortic arch double lumen aortic arch double aortic arch aortic arch anomalies congenital heart disease echocardiography
Abstract
Persistence of the fifth aortic arch is an extremely rare and controversial congenital anomaly in the development of the main arteries and large vessels with variable anatomical shapes, which may be associated with critical congenital heart disease, accompanied by impaired systemic or pulmonary blood flow. The definition and true embryological origin of this anatomical structure is still a highly debatable issue. Therefore, persistence of the fifth aortic arch is often a diagnostic problem. We describe a clinical case demonstrating the presence of an additional arterial vessel connecting the ascending and descending aorta, which is classified in the literature as one of the possible options for preserving the 5th aortic arch. The purpose of this review is to raise awareness of this extremely rare and unusual developmental anomaly.References
- Gerlis L.M., Ho S.Y., Anderson R.H., Da Costa P. Persistent 5th aortic arch – a great pretender: three new covert cases. Int. J. Cardiol. 1989; 23 (2): 239–47. DOI: 10.1016/0167-5273(89)90253-2
- Rajagopal R., Garg P.K., Khera P.S., Sharma S. “Doublelumen” aortic arch with “double-lumen” brachiocephalic artery. Ann. Pediatr. Cardiol. 2019; 12 (2): 141–3. DOI: 10.4103/apc.APC_106_18
- Kim C.H., Kim H., Choi K.H., Sung S.C., Ko H., Choo K.S. Persistent fifth aortic arch associated with aortic coarctation: a case of surgical correction without artificial material. J. Cardiothorac. Surg. 2021; 16 (1): 281. DOI: 10.1186/s13019-021-01664-y
- Lloyd D.F., Ho S.Y., Pushparajah K., Chakraborty S., Nasser M., Uemura H. et al. Persistent fifth aortic arch: The “great pretender” in clinical practice. Cardiol. Young. 2018; 28: 175–81.
- Khan S., Nihill M.R. Clinical presentation of persistent 5th aortic arch: 3 new cases. Tex. Heart Inst. J. 2006; 33 (3): 361–4.
- Gupta S.K., Bamforth S.D., Anderson R.H. How frequent is the fifth arch artery? Cardiol. Young. 2015; 25: 628–46.
- Furtado A.D., Manohar S.R., Pradhan S.K., Pillai V., Karunakaran J. Persistent left fifth aortic arch with pentalogy of Fallot. Thorac. Cardiovasc. Surg. 2012; 60: 233–5. DOI: 10.1055/s-0030-1271013
- Freedom R.M., Silver M., Miyamura H. Tricuspid and pulmonary atresia with coarctation of the aorta: a rare combination possibly explained by persistence of the fifth aortic arch with a systemicto-pulmonary arterial connection. Int. J. Cardiol. 1989; 24 (2): 241–5. DOI: 10.1016/0167-5273(89)90314-8
- Al Akhfash A.A., Al Mutairi M.B., Al Habshan F.M. Persistent fifth aortic arch diagnosed by echocardiography and confirmed by angiography: Case report and literature review. J. Saudi Heart Assoc. 2009; 21 (4): 245–8. DOI: 10.1016/j.jsha.2009.10.003
- Zhao Y.H., Su Z.K., Liu J.F., Cao D.F., Ding W.X. Surgical treatment of persistent fifth aortic arch associated with interrupted aortic arch. Ann. Thorac. Surg. 2007; 84: 1016–9.
- Lim C., Kim W.H., Kim S.C., Lee J.Y., Kim S.J., Kim Y.M. Truncus arteriosus with coarctation of persistent fifth aortic arch. Ann. Thorac. Surg. 2002; 74: 1702–4.
- Parmar R.C., Pillai S., Kulkarni S., Sivaraman A. Type I persistent left fifth aortic arch with truncus arteriosus type A3: an unreported association. Pediatr. Cardiol. 2004; 25: 432–3.
- Bernasconi A., Goo H.W., Yoo S.J. Double-barrelled aorta with tetralogy of Fallot and pulmonary atresia. Cardiol. Young. 2007; 17: 98–101.
- Van Praagh R., van Praagh S. Persistent fifth arterial arch in man. Congenital double-lumen aortic arch. Am. J. Cardiol. 1969; 24: 279–82.
- Naimo P.S., Vazquez-Alvarez Mdel C., d’Udekem Y., Jones B., Konstantinov I.E. Double-lumen aortic arch: persistence of the fifth aortic arch. Ann. Thorac. Surg. 2016; 101 (5): e155–6. DOI: 10.1016/j.athoracsur.2015.10.014
- Bamforth S.D., Chaudhry B., Bennett M., Wilson R., Mohun T.J., Van Mierop L.H.S. et al. Clarification of the identity of the mammalian fifth pharyngeal arch artery. Clin. Anat. 2013; 26 (2): 173–82. DOI: 10.1002/ca.22101
- Gupta S.K., Gulati G.S., Anderson R.H. Clarifying the anatomy of the fifth arch artery. Ann. Pediatr. Cardiol. 2016; 9: 62–7. DOI: 10.4103/0974-2069.171392
- Freedom R.M., Yoo S.-J., Mikailian H., Williams W.G. (Eds.) The natural and modified history of congenital heart disease. New York: John Wiley & Sons; 2008.
- Geva T., Ray R.A., Santini F., Van Praagh S., Van Praagh R. Asymptomatic persistent fifth aortic arch (congenital doublelumen aortic arch) in an adult. Am. J. Cardiol. 1990; 65: 1406–7.
- Kirsch J., Julsrud P.R. Magnetic resonance angiography of an ipsilateral double aortic arch due to persistent left fourth and fifth aortic arches. Pediatr. Radiol. 2007; 37: 501–2.
- Atsumi N., Moriki N., Sakakibara Y., Mitsui T., Horigome H., Kamma H. Persistent fifth aortic arch associated with type A aortic arch interruption. Histological study and morphogenesis. Jpn. J. Thorac. Cardiovasc. Surg. 2001; 49: 509–12.
- Isomatsu Y., Takanashi Y., Terada M., Kasama K. Persistent fifth aortic arch and fourth arch interruption in a 28-year-old woman. Pediatr. Cardiol. 2004; 25: 696–8.
- Carroll S.J., Ferris A., Chen J., Liberman L. Efficacy of prostaglandin E1 in relieving obstruction in coarctation of a persistent fifth aortic arch without opening the ductus arteriosus. Pediatr. Cardiol. 2006; 27: 766–8.
- Uysal F., Bostan O.M., Cil E. Coarctation of persistent 5th aortic arch: first report of catheter-based intervention. Tex. Heart Inst. J. 2014; 41: 411–3.
- Santoro G., Caianiello G., Palladino M.T., Iacono C., Russo M.G., Calabro R. Aortic coarctation with persistent fifth left aortic arch. Int. J. Cardiol. 2009; 136: e33–4.
- Yoshii S., Matsukawa T., Hosaka S., Ueno A., Tsuji A. Repair of coarctation with persistent fifth arterial arch and atresia of the fourth aortic arch. J. Cardiovasc. Surg. (Torino). 1990; 31: 812–4.
- Weinberg P.M. Aortic arch anomalies. J. Cardiovasc. Magn. Reson. 2006; 8 (4): 633–43. DOI: 10.1080/10976640600713756
- Wang J.N., Wu J.M., Yang Y.J. Double-lumen aortic arch with anomalous left pulmonary artery origin from the main pulmonary artery – bilateral persistent fifth aortic arch – a case report. Int. J. Cardiol. 1999; 69: 105–8.
- Oshitani T., Kawasaki Y., Murakami Y., Fujino M., Sasaki T., Nakamura K. et al. A double-barrelled aorta with high aortic Arch. J. Cardiol. Cases. 2021; 24 (6): 284–6. DOI: 10.1016/j. jccase.2021.05.003
- Yang H., Zhu X., Wu C., Zhao X., Ji X. Assessment of persistent fifth aortic arch by echocardiography and computed tomography angiography. Medicine (Baltimore). 2020; 99 (9): e19297. DOI: 10.1097/MD.0000000000019297
- Liu Y., Zhang H., Ren J., Cao A., Guo J., Liu B. et al. Persistent fifth aortic arch: a single-center experience, case series. Transl. Pediatr. 2021; 10 (6): 1566–72. DOI: 10.21037/tp-20-433
- Bhatla P., Chakravarti S., Axel L., Ludomirsky A., Revah G. Prenatal diagnosis of a persistent fifth aortic arch, pulmonaryto-systemic type: an unusual association with evolving aortic coarctation. Echocardiography. 2015; 32 (5): 875–7. DOI: 10.1111/echo.12850
- Tretter J.T., Crotty E.J., Anderson R.H., Taylor M.D. How should we diagnose persistence of the artery of the fifth pharyngeal arch? Pediatr. Cardiol. 2017; 38 (8): 1722–4. DOI: 10.1007/s00246-017-1665-y
- Meliota G., Lombardi M., Zaza P., Tagliente M.R., Versacci P., Scalzo G., Vairo U. Isolated persistence of the fifth aortic arch in an infant presenting with congestive heart failure. Ann. Pediatr. Card. 2020; 13: 91–4.
- Figueras-Coll M., Sabaté-Rotés A., Betrián-Blasco P., Ortuño-MuroP. Stenting coarctation of the “fifth aortic arch”: a safe and attractive therapeutic alternative to surgery. World J. Pediatr. Congenit. Heart Surg. 2020; 11 (4): np140–3. DOI: 10.1177/2150135117752895
- Tang X., Wang L., Wu Q., Tong X. Persistent fifth aortic arch with interrupted aortic arch. J. Card. Surg. 2015; 30 (3): 284–7. DOI: 10.1111/jocs.12450
- Binsalamah Z.M., Chen P., McKenzie E.D. Aortic arch advancement for type a interrupted aortic arch with persistent fifth aortic arch type B. Cardiol. Young. 2017; 27 (5): 1018–21. DOI: 10.1017/s1047951117000051
- Atsumi N., Moriki N., Sakakibara Y., Mitsui T., Horigome H., Kamma H. Persistent fifth aortic arch associated with type A aortic arch interruption. Histological study and morphogenesis. Jpn. J. Thorac. Cardiovasc. Surg. 2001; 49: 509–12.
- Linhares R.R., Silva C.E., Monaco C.G., Ferreira L.D., Gil M.A., Ortiz J., Aiello V.D. Double lumen aortic arch or persistence of fifth aortic arch? Report of a case with no associated cardiac defects and literature review. Echocardiography. 2011; 28: e143–5.
About Authors
- Olga G. Malozemova, Ultrasonic Diagnostics Physician of the Department of Ultrasound Diagnostics in Neonatology and Pediatrics, Kulakov NMRC OGP, Ultrasonic Diagnostics Physician of the Department of Ultrasound Diagnostics in Bakoulev NMRC CS; ORCID
- Rena M. Gasanova, Dr. Med. Sci., Head of the Perinatal Cardiology Center of the Federal State Budgetary Institution Bakoulev NMRC CS, Physician of Ultrasound Diagnostics of the Department of Ultrasound and Functional Diagnostics in Kulakov NMRC OGP; ORCID
- Tamara A. Yarygina, Cand. Med. Sci., Ultrasonic Diagnostics Physician, Researcher, ORCID
- Elena V. Kholmanskaya, Ultrasonic Diagnostics Physician of the Department of Ultrasound Diagnostics in Bakoulev NMRC CS, Ultrasonic Diagnostics Physician of the Department of Ultrasound Diagnostics in Neonatology and Pediatrics, Kulakov NMRC OGP; ORCID
- Khiba R. Turko, Ultrasonic Diagnostics Physician; ORCID