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Radiology
Interruption of the Aortic Arch
Built from Obstetric Imaging
What’s inside
9 sections · 48 slides
Overview
- What this deck covers
The defect itself
What is missing, how often it happens, and why
- The normal aortic arch, in one slide
- What interruption of the aortic arch means
- The break always sits before the duct
- 0.1%
- Why it happens
How the fetus copes
The duct is the whole supply line to the lower body
- The ductus arteriosus: the fetal bypass
- Fetal circulation and the ductus arteriosus
- How the fetal shunts move blood
- Where the duct joins the aorta
- Why the duct must be kept open
- Quiet inside, urgent outside
Three types
One question: where along the arch does the break sit?
- Naming the type by the site of the break
- Type A: the break sits farthest down
- Type B: the commonest one
- Type C: the break sits highest
What travels with it
The defects, the genes and the organs to check
- Almost every case has a hole between the ventricles
- Hole in the wall between the pumping chambers
- Other heart defects that travel with it
- Outside the heart, and in the genes
Finding it on ultrasound
Four views, one recurring theme: right big, left small
- The one thing that gives it away
- The order to scan in
- Four-chamber view
- Ventricular disproportion on the scan
- Outflow tracts
- Three-vessel and trachea view
- Small aorta beside a large pulmonary artery
- Sagittal view: the missing curve
- W, V or straight: reading the ascending aorta
- Aorta running straight to the neck
- Straight aortic course with forward flow
- Colour Doppler of the straight aortic course
- Four-dimensional echocardiography
- Classic signs
The look-alike
Telling an interrupted arch from a coarctation
- Coarctation of the aorta: the hard call
- Duct, aorta and a coarctation side by side
Before and after birth
Testing, monitoring, delivery planning and surgery
- Before birth: what to offer
- At birth: hold the duct open
- Surgery: one stage or two
- Which surgical plan, and why
- 10%
- Later problems to watch for
Take it away
What the referring doctor needs, and the key points
- What the referring doctor needs to know
- Key points
- References
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition