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Ann Thorac Surg 2007;83:2226-2228
© 2007 The Society of Thoracic Surgeons

Case Reports

Rare Presentation of Subclavian Artery Isolation in a Neonate With a Family History of Aortic Arch Anomalies

Hutan Ashrafian, MRCS*, Victor Tsang, MD, FRCS, Martin Kostolny, MD

Department of Cardiothoracic Surgery, London, United Kingdom

Accepted for publication November 13, 2006.

* Address correspondence to Dr Ashrafian, Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, WC1N 3JH, United Kingdom (Email: ashrafian{at}email.com).

Isolation of the left subclavian artery is a rare aortic arch anomaly in which the artery originates from the pulmonary artery through a ductus arteriosus rather than the aorta. In neonates it is usually diagnosed incidentally with other aortic or cardiac anomalies and can be associated with chromosomal deletions. We describe an extremely rare presentation whereby subclavian artery isolation was presented with left arm ischemia in a 6-day-old child. There were also a concurrent right aortic arch, ventricular septal defect, persistent left superior vena cava, and both radial and ulnar artery hypoplasia. A family history of aortic arch anomalies with no known chromosomal aberration was also present, whereby all the male family members on the maternal side had undergone aorto-cardiac surgery as neonates. Diagnosis and surgical management are discussed.






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