A Study on the Anatomical Organization
of the Aortic Arch Anomalies
Dr. Sunitha Vinnakota
Department of Anatomy, MIMS, Nellimarla,
Vizianagaram (Dist.), AP., India.
The day to day advances in the fields of cardiac and vascular surgeries need to revive interest in the developmental and the adult anatomies of the Aortic Arch (AA) and its great vessels. A variant aortic arch branching pattern may occur with different embryological mechanisms. The variations in the branching pattern of the aortic arch may range from differences in the distance between the origins of the different branches to the number of branches. The present study was undertaken to study the variations in the branching pattern of the arch of the aorta and their surgical applications.
In the present study, the anatomical characteristics of the aortic arch and its branches were evaluated by doing a macroscopic examination which has diagnostic and surgical importance.
This study was conducted on 35 cadavers from the Anatomy Department, 100 aortic angiographic studies were done at the Care Hospital, Visakhapatnam and 300 CT angiographic studies were done at Vijaya Medical Centre, Visakhapatnam. This study was carried out by the conventional dissection method and by doing angiograms.
The normal branching pattern was observed in 26 specimens out of the 35 cadavers. The common trunk for both the brachiocephalic and the left common carotid arteries was present in 5 specimens. The left vertebral artery arose from the aortic arch between the left common carotid and the left subclavian artery in 4 specimens. Among these 4 cases, in 1 cadaver, the cervical segment of the left vertebral artery was very long and it entered through the foramen transversarium of the 3rd cervical vertebra. Whereas, in 1 cadaver, there were three branches which arose from the aortic arch, (1) the common trunk of the brachiocephalic and the left common carotid arteries (2) the left vertebral artery and (3) the left subclavian artery.
Knowledge on the variations in the classical branches of the aortic arch is important in the diagnosis of intracranial aneurysms which occur after a subarachnoid haemorrhage. Clinicians and surgeons should be aware of the aortic arch variations. Prior identification of these vascular anomalies through diagnostic interventions is crucial, in order to avoid complications during heart and vascular surgeries.