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      Persistance du 5 ème arc aortique associé à une interruption de l’arche aortique Translated title: Persistence of the 5 th aortic arch associated with interruption of the aortic arch

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          Abstract

          Les auteurs rapportent un cas de persistance du 5 ème arc aortique associé à une interruption totale de l'arche aortique. Ce cas clinique montre le piège diagnostic posé par la persistance du 5 ème arc aortique et son effet bénéfique hémodynamique. Le tableau clinique était trompeur en préopératoire en raison de la persistance des pouls fémoraux et des signes cliniques d'un shunt gauche-droite via un large canal artériel. Le diagnostic a été redressé en peropératoire grâce au monitorage de la pression artérielle par un cathéter placé dans l'artère fémorale.

          Translated abstract

          We report a case of persistence of the 5th aortic arch associated with total interruption of the aortic arch. This clinical case shows the diagnostic pitfall of the persistence of the 5th aortic arch and its beneficial hemodynamic effect. Preoperative clinical picture was misleading, due to the persistence of femoral pulses and clinical signs of left-to-right shunt via a wide ductus arteriosus. The diagnosis was intraoperatively adjusted on the basis of blood pressure monitoring using catheter placed into the femoral artery.

          Most cited references19

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          Persistent fifth arterial arch in man. Congenital double-lumen aortic arch.

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            Persistent 5th aortic arch--a great pretender: three new covert cases.

            Although persistence of the embryonic fifth aortic arch is considered a rare congenital malformation, analysis of the records of the cardiopathological collections of the Brompton and Killingbeck Hospitals reveals 6 examples in approximately 2000 specimens, an incidence amongst our material of 1 in 330. Since our review of the literature reveals only a further 13 described cases, we wonder if the condition may go unrecognized rather than being exceedingly rare. This possibility is further supported by the fact that 3 of our cases were incorrectly interpreted when initially described. In this report, we describe the details of 2 of these specimens and one other case that was not included in our earlier descriptions of this malformation. The first case had the persistent fifth arch as a conduit between the pulmonary and systemic circulations in the setting of aortic atresia with interruption of the aortic arch. The second case demonstrated a double lumen aortic arch, the fifth arch in this instance being an accessory systemic-to-systemic conduit. In the final case, the persistent arch was initially considered to represent an aorto-pulmonary window but review revealed an aortic to pulmonary conduit more in keeping with the presence of a fifth arch. We conclude that the powers of mimicry of this enigmatic structure may account for its apparent rarity.
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              Persistent fifth aortic arch. A report of two new cases and a review of the literature.

              Two new cases of persistent fifth aortic arch are described, one with a distal connexion to the pulmonary circulation and the other to the systemic circulation. The previously reported cases are reviewed and the advantages conferred clinically by persistence of this structure are noted.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                09 August 2017
                2017
                : 27
                : 265
                Affiliations
                [1 ]Service de Chirurgie Cardiovasculaire, Hôpital Militaire Mohamed V, Rabat, Maroc
                [2 ]Service de Réanimation, Hôpital Militaire Mohamed V, Rabat, Maroc
                Author notes
                [& ]Corresponding author: Noureddine Atmani, Service de Chirurgie Cardiovasculaire, Hôpital Militaire Mohamed V, Rabat, Maroc
                Article
                PAMJ-27-265
                10.11604/pamj.2017.27.265.4249
                5660329
                d177e19a-37a8-4386-86d1-b74e9c73bfa7
                © Mahdi Ait Houssa et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 April 2014
                : 03 March 2015
                Categories
                Case Report

                Medicine
                persistance du 5ème arc aortique,interruption de l´arche aortique,anomalies des arcs aortiques,chirurgie cardiaque,persistence of the 5th aortic arch,interruption of the aortic arch,abnormalities of the aortic arches,cardiac surgery

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