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Pediatric Cardiology

, Volume 31, Issue 2, pp 280–282 | Cite as

Tetralogy of Fallot with Persistent Fifth Aortic Arch: Echocardiographic Diagnosis

  • Gerard HolmesEmail author
  • Joanna L. Holmes
  • William BermanJr.
  • Steven Yabek
Case Report

Abstract

Although persistent, fifth aortic arch (P5A) is an uncommon anomaly. Its incidence is unknown due largely to failure of recognition. Fundamental to its diagnosis is an adequate understanding of the various settings in which P5A may manifest. One of the more frequently reported manifestations of this unusual anomaly is a systemic-to-pulmonary connection in the presence of pulmonary atresia, with or without a ventriculoseptal defect. This report describes a new case of P5A in an infant with tetralogy of Fallot but not pulmonary atresia, which was diagnosed echocardiographically. The echo-Doppler characteristics of P5A in the presence of right ventricular outflow obstruction are described, and the implications regarding surgery for the accompanying defects are discussed. To the authors’ best knowledge, the described case is the first reported instance of P5A in this specific setting.

Keywords

Echocardiography Persistent 5th aortic arch Tetralogy of fallot 

Supplementary material

Supplementary material 1 (AVI 1323 kb)

Supplementary material 2 (AVI 983 kb)

246_2009_9573_MOESM3_ESM.bmp (485 kb)
Supplementary material 3 (BMP 484 kb)

References

  1. 1.
    Cabera A, Galdeano J, Lekuona I (1985) Persistent left sided fifth arch in a neonate. Br Heart J 54:105–106CrossRefGoogle Scholar
  2. 2.
    Gerlis LM, Dickensen DF, Wilson N, Gibbs JC (1987) Persistent fifth aortic arch: a report of two new cases and a review of the literature. Int J Cardiol 16:185–192CrossRefPubMedGoogle Scholar
  3. 3.
    Gerlis LM, Ho SY, Anderson RH, Da Costa P (1989) Persistent 5th aortic arch: a great pretender: three new covert cases. Int J Cardiol 23:239–247CrossRefPubMedGoogle Scholar
  4. 4.
    Gibbin CL, Midgley FM, Potter BM, Martin GR (1991) Persistent left 5th aortic arch with a complex coarctation. Am J Cardiol 67:319–320CrossRefPubMedGoogle Scholar
  5. 5.
    Khan S, Nihill M (2006) Clinical presentation of persistent 5th aortic arch: 3 new cases. Tex Heart Inst J 33:361–364PubMedGoogle Scholar
  6. 6.
    Konishi T, Iizima T, Onai K, Kobayashi G, Anzai T (1981) Persistent 5th aortic arch with coarctation of the aorta and aneurysm of the left subcalvian artery. Nippon Kyobu Geka Gakkai Zasshi 29:1243–1248PubMedGoogle Scholar
  7. 7.
    McMahon CJ, Kertesz NJ, Vick GW (2002) Delineation of persistent fifth aortic arch using magnetic resonance angiography. Cardiol Young 12:484–485CrossRefPubMedGoogle Scholar
  8. 8.
    Peirone AR, Freedom RM, Yoo S-J (2003) Persistent 5th aortic arch. In: Freedom RM (ed) The natural and modified history of congenital heart disease. Futura, Blackwell Publishing, New York, pp 488–491CrossRefGoogle Scholar
  9. 9.
    Van Praagh R, Van Pragg S (1969) Persistent 5th arch in man: congenital double aortic arch lumen. Am J Cardiol 24:279–282CrossRefPubMedGoogle Scholar
  10. 10.
    Zartner P, Schneider MB, Bein G (2000) Prostaglandin E1 sensitive persistent 5th aortic arch type 2. Heart 84:142–145CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Gerard Holmes
    • 1
    Email author
  • Joanna L. Holmes
    • 1
  • William BermanJr.
    • 1
  • Steven Yabek
    • 1
  1. 1.Pediatrix Cardiology Associates of New MexicoAlbuquerqueUSA

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