Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T07:32:34.317Z Has data issue: false hasContentIssue false

An anatomical study of 110 cases with deficiency of the aorticopulmonary septum with emphasis on the role of the arterial duct

Published online by Cambridge University Press:  19 August 2008

Leon M. Gerlis*
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
Candida C. d'A. MacGregor
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
Siew Yen Ho
Affiliation:
From the Department of Paediatrics, National Heart and Lung Institute, London
*
Dr. Leon M. Gerlis, Department of Paediatrics, National Heart and Lung Institute, Dovehouse Street, London SW36LY, United Kingdom. Tel. 44-71-351-8940.

Abstract

To assess the prevalence and role of the arterial duct in hearts with incomplete development of the aorticopulmonary septum, 110 autopsy specimens, comprising 100 examples of common arterial trunk and 10 cases with aorticopulmonary window, were studied. In addition to intracardiac malformations, these specimens were analyzed to determine the side of the aortic arch, the presence and location of any interruption of the arch, the presence of any anomaly of origin and course of the subclavian arteries, and the status of the arterial duct. The arterial duct was present in 33 cases, absent in 63 cases and undetermined in four cases with common arterial trunk. The duct provided an essential pathway for flow in the 20 cases with interrupted aortic arch, and in two cases with interruption of the proximal portion of the left pulmonary artery. The presence of the duct in 11 cases, in functional terms, was not essential. In the 10 hearts with aorticopulmonary window, the duct was present in eight. It was an obligatory part of the circulatory pathways in three cases where the aortic arch was interrupted. The prevalence of non-obligatory ducts was 71% in hearts with aorticopulmonary window compared to 15% in hearts with common arterial trunk. The prevalence of the duct in cases with aorticopulmonary window suggests this lesion is a later developmental defect. The functional role of an arterial duct in these hearts should be properly assessed in the clinical situation.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Van Praagh, R, Van Praagh, . The anatomy of common aorticopulmonaiy trunk (Truncus Arteriosus Communis) and its embryological implications. Am J Cardiol 1965; 16: 406425.CrossRefGoogle Scholar
2.Collett, RW and Edwards, JE. Persistent truncus arteriosus: a classification according to anatomic types Surg Clin N America 1949; 29: 12451270.Google Scholar
3.Bharati, S, McAllister, HA, Rosenquist, GC, Miller, RA, Tatooles, CJ, Lev, M. The surgical anatomy of Truncus Asteriosus Communis. J Thorac Cardiovasc Surgery 1974; 67: 501510.CrossRefGoogle Scholar
4.Calder, L, Van, Praagh R, Van Praagh, S, Sears, WP, Corwin, R, Levy, A, Keith, JD, Paul, MH. Truncus Arteriosus Communis. Amer Heart J 1976; 92: 2338.CrossRefGoogle ScholarPubMed
5.Crupi, G, Macartney, FJ, Anderson, RH. Persistent Truncus Arteriosus. A study of 66 autopsy cases with special reference to definition and morphogenesis. Amer J Cardiol 1977; 40; 569578.CrossRefGoogle ScholarPubMed
6.Gerlis, LM, Ho, S-Y, Anderson, RH, Da, Costa P. Persistent 5th aortic arch—a great pretender: three new covert cases. Int J Cardiol 1989; 23: 239247.CrossRefGoogle ScholarPubMed
7.Gerlis, LM, Dickinson, DF, Wilson, N, Gibbs, JL. Persistent fifth aortic arch. A report of two new cases and a review of the literature. Int J Cardiol 1987; 16: 185192.CrossRefGoogle Scholar
8.Coleman, EN, Barclay, RS, Reid, JM, Stevenson, JG. Congenital aorto-pulmonary fistula combined with persistent ductus arteriosus. Brit Heart J 1967; 29: 571576.CrossRefGoogle ScholarPubMed
9.Neufeld, HN, Lester, RG, Adams, P, Andersen, RC, Lillelei, CW, Edwards, JE. Aortic pulmonary septal defect. Amer J Cardiol 1962; 9: 1225.CrossRefGoogle Scholar
10.Deverall, PB, Aberdeen, E, Bonham-Carter, RE, Waterston, DJ. Aortic pulmonary window. J Thorac Cardiovasc Surg 1960; 57: 479486.CrossRefGoogle Scholar
11.Somerville, J. Aortic pulmonary septal defect. Guy’s Hosp Reports 1959; 108: 177193.Google Scholar
12.Perelman, H, Putschar, WGJ. Congenital communication between aorta and pulmonary artery. Report of a case and review of the literature. Bull Int Med Museums 1949; 30: 114.Google Scholar
13.Baronofsky, ID, Gordon, AJ, Grishman, A, Steinfeld, L, Kreel, I. Aortic pulmonary septal defect. Diagnosis and report of a case successfully treated. Amer J Cardiol 1960; 5: 273276.CrossRefGoogle Scholar