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大動脈弓과 그 分枝의 先天性畸形

CONGENITAL ANOMALIES OF AORTIC ARCH AND ITS BRANCHES

중앙의학 1961년 1권 1호 p.41 ~ 44
安承鳳, 崔炳肅,
소속 상세정보
安承鳳 (  ) - 延世大學校 醫科大學 放射線科學敎室
崔炳肅 (  ) - 延世大學校 醫科大學 放射線科學敎室

Abstract


The major anomalies of the aortic arch and great- vessels at the base of the heart have been well known to anatomists and pathologist for many years, but until the present time many of these anomalies have been considered of academic interest only. There have become increasingly important from the clinical and roentgen standpoint since 1945, when Gross reported the diagnosis and first successful surgical treatment of congenital malformation of aortic arch and its branches.
There are six pairs of aortic arches that developed at various times in the embryo. The cephalad arches develop first only to disappear as the more distal one develops. The final normal pattern of development is thought to be as follows : the proximal part of the third arch becomes the common carotid. The left fourth becomes the aorta, while the proximal part of the right fourth arch becomes incorporated in the right subclavian. The proximal parts of the sixth becomes the pulmonary arteries, and the distal part of the left sixth becomes the ductus arteriosus. Normally, the other portions of the arches disappear. Anomalies of the great vessels result from persistence of normally obliterated arches or segment, with disappearance of portions that should normally be present.
In this paper the, discussion will be limited to the roentgen diagnosis and it is to be emphasized that in many of these conditions the diagnosis can be made only by means of an adequate roentgenologic examination.
The diagnosis of right aortic arch can be frequently suspected from the posterioanterior roentgenogram alone as the aortic arch may be observed to the right of the midline with absence of the aortic knob from its usual Position. The main portion of the shadow of the knob is cast by the descending limb of the aortic arch and, as this limb lies either in the midline or to the right of the midline in most cases, the knob is not seen in its usual position. In addition, there may be very slight deviation of the trachea to the left. The determination of the exact type of right aortic arch must be made by observing tae deflections and defects in the barium filled esophagus.
In. our 3 patients of congenital anomalies of aortic arch, the roentgen changes appeared to be unmistakable and characteristics on the film taken in posterioanterior and both anterior oblique view with contrast media.

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