Aortic Arch And Variations In Its Branching Pattern 3134-3143
Assistant Professor, Department of Anatomy,
Saveetha Medical College & Hospital,
Saveetha University, Saveetha Nagar,
Thandalam, CHENNAI â€“ 602 105,E-mail:email@example.com
Background: The relationship of the arch of the aorta and its branches are embryologically determined and are found to be highly variable. This makes the arch of the aorta more vulnerable to injury during the surgical manipulation of the heart, lungs and the great vessels. The arch anomalies produce tracheo-oesophageal constriction, which accounts for 1%-2% of all congenital heart defects. The present study was undertaken to study the variations in the branching pattern of the arch of the aorta in the South Indian population and their surgical applications.
Aim: An extensive analysis of the arch of the aorta, which is surgically important, was done under the following headings such as origin, whether it is a left or right-sided aortic arch, the normal branching pattern of the aortic arch and variations in the branching pattern of the aortic arch.
Methods: The study material included 75 specimens consisting of 16 dissection room cadavers, 34 post - mortem en - bloc specimens and 25 patients who underwent angiograms. The study was carried out by using the conventional dissection method and angiograms. The radio graphical imaging of the arch of the aorta and its branches were obtained by the Angiogram, which combines the use of cineangiocardiography and aortography.
Results: The left aortic arch was found in 73 specimens (97.3%) and the right aortic arch in 2 specimens (2.67%). The normal branching pattern was present in 41 male specimens (89.1%) and in 24 female specimens (88.8%). The common origin for both the brachiocephalic and the left common carotid artery was present in 4 specimens (5.48%). 6.52% male specimens and 3.7% female specimens showed this variation. For the left vertebral artery arising from the aortic arch between the left common carotid and the left subclavian artery, 2.17% out of 46 male specimens and 7.4% out of 27 female specimens showed this variation. This type of variation was present in 4.1%. 73 specimens that had left aortic arch werevtaken and studied for right vertebral artery arising as fourth branch from the aortic arch. 1.36% showed this type of variation.
Conclusion:From the results of our present study, we conclude that no specific south Indian variation beyond the limits of average fluctuation was noted and also, the variations are not only clinically important, but are also clinically important to both the patient as well as the operating surgeons.