What Is an Interrupted Aortic Arch?

The aortic arch is the curved part of the aorta. The descending aorta moves at the lower edge of the 4th thoracic spine. From the convex side of the arch, three larger arteries are issued, which are divided into innocuous artery, left common carotid artery, and left subclavian artery in order from right to left. The front of the aortic arch is the sternal stalk, and the right rear has trachea and esophagus. There are baroreceptors in the aortic arch. It has the effect of regulating blood pressure. Below the aortic arch, there are 2 to 3 miliary bodies, called aortic bulbs, which are chemoreceptors.

The aortic arch is the curved part of the aorta. The descending aorta moves at the lower edge of the 4th thoracic spine. From the convex side of the arch, three larger arteries are issued, which are divided into innocuous artery, left common carotid artery, and left subclavian artery in order from right to left. The front of the aortic arch is the sternal stalk, and the right rear has trachea and esophagus. There are baroreceptors in the aortic arch. It has the effect of regulating blood pressure. Below the aortic arch, there are 2 to 3 miliary bodies, called aortic bulbs, which are chemoreceptors.

Chinese name

Aortic arch

Foreign name

aortic arch

Location

Aortic arch after right 2nd thoracic rib joint

Present

Arch backwards

Lower edge

Flat sternum angle

Features

Arterial arch position slightly higher

Aortic arch anatomy:

1. Aortic arch:

The aortic arch is a continuation of the ascending aorta and is located in the superior mediastinum behind the sternal stem. From the height of the second thoracic rib joint on the right side, it turns to the left and rear in an arcuate shape, reaching the left lower edge of the fourth thoracic vertebra, and then turns downward to descend the aorta. The total length of the aortic arch is about 5-6 centimeters, and the arterial ligament is connected between the lower wall and the bifurcation of the pulmonary artery (the remains after the arterial duct is blocked), and it is adjacent to the left bronchus. Below the aortic arch and in the wall, there are chemoreceptors and pressure sensors, respectively. It is rich in sensory nerve endings from the vagus nerve. They can separately sense the stimulation of changes in blood composition and pressure, and have a reflexive effect on regulating breathing and blood pressure.

On the convex side (upper wall) of the aortic arch, the three branches of the head and arm trunk (anonymous arteries), the left common carotid artery, and the left subclavian artery are issued from right to left. They are the arterial trunks that supply blood to the head and neck and upper limbs.

Aortic arch (4 photos)

2. Aorta:

The aorta is the main artery of the systemic circulation, so it is called the aorta, which is also the largest artery in the body. From the left ventricle, travel from the right side of the pulmonary artery to the front right and up, to the height of the right thoracic rib joint on the right, turn in an arcuate direction to the left and back to the left side of the lower edge of the 4th thoracic vertebra, and then turn downward, along the spine. Anterior descend to the height of the 12th thoracic vertebra, the aortic puncture that penetrates the diaphragm enters the abdominal cavity, and continues to descend from the front of the spine to the lower edge of the 4th lumbar vertebra. The left and right common iliac arteries and a small middle iliac artery. According to the running and location of the aorta, it can be divided into three sections: ascending aorta (ascending aorta), aortic arch, and descending aorta (descending aorta). The descending aorta is divided into the aortic rupture of the iliac crest and is divided into the thoracic aorta (aortic chest) and abdominal aorta (aortic abdomen).

Aortic arch morphological structure:

The aortic arch is a continuation of the ascending aorta. From the equivalent of the second thoracic rib joint on the right side, it is bowed to the left and rear, spanning the front of the trachea, and renamed the descending aorta to the left of the lower edge of the fourth thoracic vertebra. It is named because it has an arcuate shape on the sternal angle plane flange upwards and to the left. The upper edge of the aortic arch generally corresponds to the midpoint of the sternal stem. The high aortic arch can reach or exceed the upper edge of the sternal stem. The aortic arch is complicatedly adjacent. Between its left front and left mediastinal pleura, there are left phrenic nerve, left pericardial iliac vessels, left vagus nerve and left sympathetic heart branch, left vagus nerve trunk, left superior intercostal vein, and left head arm vein transverse Pass the upper part of the front of the aortic arch; there are trachea, esophagus, thoracic duct, left recurrent laryngeal nerve, deep cardiac plexus, etc. at the rear left; trachea branch and left main bronchus, pulmonary artery trunk and its branches, left recurrent laryngeal nerve, arterial ligament, heart Shallow clumps and so on. The aortic arch flange extends from the right anterior to the left rear, and branches out into the three branches of the head and arm trunk, the left common carotid artery, and the left subclavian artery. Because the aortic arch is closely related to the trachea and left main bronchus, aortic arch tumors are prone to produce respiratory symptoms. If the tumor presses the esophagus backwards, it will cause difficulty swallowing, such as affecting the left recurrent laryngeal nerve, which can affect pronunciation. The anterior and posterior X-ray image can be seen at the end of the aortic arch, called the aortic arch knot; the left anterior oblique and lateral image can be seen from the entire view of the aortic arch; the transparent area below the aortic arch, called the aortic window, with the pulmonary artery trunk and the left pulmonary artery in the window . During the development of the aortic arch, many variations can occur. Common aortic arches, double aortic arches, and branching of the aortic arch are common. There are baroreceptors in the aortic arch wall, and special sensory nerve endings are distributed to regulate blood pressure. Below the aortic arch, there are 2 to 3 miliary bodies, called aortic bodies, or aortic globules, which are chemoreceptors.

Aortic arch and aortic arch-related diseases:

Aortic arch rupture:

Overview:

A congenital vascular malformation in which a part of the aortic arch is absent or blocked, causing interruption of blood flow between the ascending and descending aorta. Its incidence is less than 1%. According to the anatomical characteristics, the aortic arch is broken or absent, and the aortic arch atresia is divided into two types. The main clinical manifestations: early heart failure, developmental disorders, differential cyanosis, blood pressure and pulsation of limbs, and pulmonary hypertension symptoms. Electrocardiogram, X-ray, echocardiography, cardiac catheterization and arteriography are helpful for diagnosis. Early natural mortality of this disease is very high, so it is advisable to surgical treatment as soon as possible. However, the mortality rate remains high (30% to 60%). Complicated deformity is an important factor affecting the effect of surgical treatment.

Types of:

The disease refers to the partial disruption of the aortic arch due to abnormal embryonic development, forming a blind cord. According to the aortic arch interruption site, it is divided into three types: Type A: the disconnection is located at the distal end of the left subclavian artery; Type B: the disconnection is located between the left subclavian artery and the left common carotid artery; Type C: the disconnection is located between the innominate artery and the left Between the common carotid arteries. Almost all patients were combined with patent ductus arteriosus and ventricular septal defect. The clinical symptoms are similar to the narrowing of the precatheter aorta, but they are more severe. Auscultation of the heart may be free of murmurs or systolic murmurs produced by ventricular defects in the 3 and 4 intercostal spaces on the left margin of the sternum. Characteristic manifestations are a series of manifestations caused by the difference in upper and lower limb blood pressure. X-ray examination and electrocardiogram are similar to aortic constriction. Two-dimensional echocardiography and retrograde aortic angiography can confirm the diagnosis. For surgical treatment, the earlier the age of surgery, the better.