Is surgery necessary for adults with Isolated Interrupted Aortic Arch?:
Case series with literature review
Abstract
Background and Aim: Interrupted aortic arch (IAA) is defined as a
complete interruption of aortic lumen between the ascending and
descending aorta. It is an uncommon and complicated congenital heart
disease with high mortality in infants. It is rare for patients with
isolated IAA to survive to adulthood without operation unless the
extensive collateral vessels joining the descending aorta. Here we
present three unique cases with isolated IAA together with a review of
the literature. Methods: case presentation: We retrospectively searched
the hospital patient databases for patients (>14 years)
with IAA diagnosed at the Wuhan Union Hospital over the past 10 years
and excluded the patients with other cardiac malformations. Three
patients were identified. Two were referred to us for hypertension
management and were diagnosed with IAA at our hospital. They both
declined surgical treatments and underwent conservative therapy
including management of their hypertension. One patient was referred to
our hospital for further treatment options after the patient was
diagnosed with IAA at another hospital. This patient received an
extra-anatomic bypass surgery from ascending aorta to descending aorta.
His high blood pressure did not resolve and was subsequently managed by
anti-hypertensives medications after the surgery. Discussion and
conclusions: Adult patients with isolated IAA usually have extensive
collateral vessels joining the descending aorta. Surgical intervention
may not be necessary for these patients if the patients have no symptoms
except hypertension. Anti-hypertensives medical management with long
term follow-up appears to be a reasonable treatment option for these
patients.