Interruption of the Aortic Arch Without a Patent Ductus Arteriosus

Abstract

Complete interruption of the aortic arch without a patent ductus arteriosus is compatible with survival for many years. This is demonstrated by the case reported herein and two others reported in the literature. With no connection between the ascending and the descending aorta and with both subclavian arteries coming off the descending aorta, blood supply to the entire body, except for the head, was by retrograde flow through the vertebral arteries and left cervical collaterals. Bounding carotid pulsations with diminished arm and leg pulses are apparent in this anomaly. Surgical restoration of the continuity between the ascending and the descending aorta was successful in this case and the two previously reported cases. The surgical results of all cases of interruption or atresia of the aortic arch, including those with a patent ductus arteriosus, are reviewed, and the appearance of the ascending aorta on angiography is suggested as a possible differential point between interruption and atresia of the aortic arch.