Summary
A patient with pulmonary atresia and a ventricular septal defect is described in whom an arterial branch from the distal ascending aorta supplied segments of both lungs. The branch is considered to represent a persistent fifth aortic arch. The possible morphogenesis and differential diagnosis of a communication between the ascending aorta and the pulmonary artery in pulmonary atresia with ventricular septal defect are discussed.
Similar content being viewed by others
References
Anderson RH, Macartney FJ, Shinebourne EA, Tynan M (1987) Pulmonary atresia with ventricular septal defect. In:Paediatric cardiology. Churchill Livingstone, Edinburgh, pp 799–827
Congdon ED (1922) Transformation of the aortic-arch system during the development of the human embryo. Carnegie Institute of Washington Publications 277.Contrib Embryol 68:47–110
Freedom RM, Culham JAG, Moes CAF (1984) Tetralogy of Fallot. In:Angiography of congenital heart disease, MeMillan Publishing, New York, pp 173–213
Freedom RM, Silver M, Miyamura H (1989) Tricuspid and pulmonary atresia with coarctation of the aorta: a rare combination possibly explained by persistence of the fifth aortic arch with a systemic-to-pulmonary arterial connection.Int J Cardiol 24:241–245
Gerlis LM, Dickinson DF, Wilson N, Gibbs JL (1987) Persistent fifth aortic arch. A report of two new cases and a review of the literature.Int J Cardiol 16:185–192
Gerlis LM, Ho SY, Anderson RH, Da Costa P (1989) Persistent 5th aortic arch — great pretender: three new covert cases.Int J Cardiol 23:239–247
Kutsche LM, Van Mierop LHS (1988) Anomalous origin of a pulmonary artery from the ascending aorta: associated anomalies and pathogenesis.Am J Cardiol 61:850–856
Macartney FJ, Scott O, Deverall PB (1974) Haemodynamic and anatomical characteristic of pulmonary blood supply in pulmonary atresia with ventricular septal defect — including a case of persistent fifth aortic arch.Br Heart J 36:1049–1060
Moes CAF, Benson LN, Burrows PE, Freedom RM, Williams W, Duckworth JWA (1991) The subclavian artery as the first branch of the aortic arch.Pediatr Cardiol 12:39–43
Van Praagh R, Van Praagh S (1969) Persistent fifth arterial arch in man. Congenital double-lumen aortic arch.Am J Cardiol 24:279–282
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yoo, SJ., Moes, C.A.F., Burrows, P.E. et al. Pulmonary blood supply by a branch from the distal ascending aorta in pulmonary atresia with ventricular septal defect: Differential diagnosis of fifth aortic arch. Pediatr Cardiol 14, 230–233 (1993). https://doi.org/10.1007/BF00795377
Issue Date:
DOI: https://doi.org/10.1007/BF00795377