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J Thorac Cardiovasc Surg 2005;130:215-216
© 2005 The American Association for Thoracic Surgery

Brief Communication

Embryologic and surgical considerations in tetralogy of Fallot with right arch and aberrant left subclavian artery from the ascending aorta

Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Received for publication October 20, 2004; accepted for publication November 1, 2004.

^_* Address for reprints: Professor Shyam Krishnan KG, Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India 695 011.

The first 20% of the full text of this article appears below.

Left to right: Sai Kiran, Neelakandhan, Shyam Krishnan, Theodore

Anomalies of the right aortic arch are common in tetralogy of Fallot (TOF). Aberrant left subclavian artery (LSA) from the Kommerell diverticulum and isolation of the LSA are occasionally encountered. LSA arising as the first branch of a right aortic arch has been reported1; however, this is the first report of aberrant LSA arising from the ascending aorta in TOF with a right aortic arch.

Clinical Summaries

PATIENT 1. A 12-year-old boy had a history of cyanosis since 3 months of age. TOF was diagnosed when he was 3 months old, and he was lost to follow-up. On examination all peripheral pulses were palpable, and blood pressure was 110/70 mm Hg in both the upper limbs. Both heart sounds were heard, and there was a grade 3/6 ejection systolic murmur over the second left intercostal space. Preoperative blood chemistry, hematology, and coagulation profile showed normal results. Chest radiography and electrocardiogram were consistent with TOF. Transthoracic echocardiography showed a right . . . [Full Text of this Article]

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