Clarifying the anatomy of the fifth arch artery

被引:34
作者
Gupta, Saurabh Kumar [1 ]
Gulati, Gurpreet Singh [2 ]
Anderson, Robert H. [3 ]
机构
[1] All India Inst Med Sci, Dept Cardiol, New Delhi 110029, India
[2] All India Inst Med Sci, Dept Cardiac Radiol, New Delhi 110029, India
[3] Newcastle Univ, Inst Med Genet, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
关键词
Bovine arch; cardiac development; double-barreled aorta; fifth arch artery;
D O I
10.4103/0974-2069.171392
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The artery allegedly forming in the fifth pharyngeal arch has increasingly been implicated as responsible for various vascular malformations in patients with congenitally malformed hearts. Observations from studies on developing embryos, however, have failed to provide support to substantiate several of these inferences such that the very existence of the fifth arch artery remains debatable. To the best of our knowledge, in only a solitary human embryo has a vascular channel been found that truly resembled the artery of the fifth arch. Despite the meager evidence to support its existence, the fifth arch artery has been invoked to explain the morphogenesis of double-barreled aorta, some unusual forms of aortopulmonary communications, and abnormalities of the brachiocephalic arteries. In most of these instances, the interpretations have proved fallible when examined in the light of existing knowledge of cardiac development. In our opinion, there are more plausible alternative explanations for the majority of these descriptions. Double-barreled aorta is more likely to result from retention of the recently identified dorsal collateral channels while abnormalities of brachiocephalic arteries are better explained on the basis of extensive remodeling of aortic arches during fetal development. Some examples of aortopulmonary communications, nonetheless, may well represent persistence of the developing artery of the fifth pharyngeal arch. We here present one such case - a patient with tetralogy of Fallot and pulmonary atresia, in whom the fifth arch artery provided a necessary communication between the ascending aorta and the pulmonary arteries. In this light, we discuss the features we consider to be essential before attaching the tag of "fifth arch artery" to a candidate vascular channel.
引用
收藏
页码:62 / 67
页数:6
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