Aortic arch

The aortic arch represents an aorta bend at the level of a breast with transition through the left bronchial tube on the left.

Structure and arrangement of an aortic arch

The aortic arch moves up in the descending aorta with small camber and a bend back. Ahead of an arch there is a small narrowing which is called an aorta isthmus. This isthmus is located between an aortic arch and the descending aorta.

The aortic arch is directed from the second cartilage of an edge to the left 3-4 chest vertebrae. In certain cases branches of an aortic arch reach a brachiocephalic trunk and the right carotid artery, and also there can be development options at which there is a connection of branches of an aortic arch and two brachiocephalic trunks – right and left.

The aortic arch connects to three large vessels - the general carotid artery, a subclavial artery and a brachiocephalic trunk. The largest vessel 4 cm long is the brachiocephalic trunk. It departs from an aortic arch at the level of a sternal and clavicular joint up and is divided into two branches – the right carotid artery and the right subclavial artery. At some features of anatomic development in the person the lowest thyroid artery can depart from a brachiocephalic vessel.

Inborn deformation of an aortic arch

At some cases of abnormal development of an aortic arch there can be its inborn tortuosity which is called deformation. This anomaly of development occurs at 0,4-0,6% of patients with cardiovascular diseases and 3% of patients with aorta coarctation.

Inborn tortuosity of an aortic arch is expressed in its lengthening, an excess and pathological thinning of walls of vessels. In certain cases the aortic arch is condensed and has symptoms of a stenozirovaniye (narrowing).

The reasons of deformation are not established, but medical researches showed that this anomaly begins during pre-natal development under the influence of a number of factors and genetic predisposition.

There are two main types of deformation:

• Inborn deformation with lengthening and bends of an artery;
• Inborn deformation at which the aortic arch is condensed and walls of vessels are narrowed.

Further deformation can develop in several defects:

• Defect with an excess between sleepy and anonymous arteries;
• Defect with an excess of the left sleepy and subclavial arteries;
• Defect with an aorta excess in the place of a branching of a subclavial artery.

In overwhelming number of cases at deformation of an aortic arch of disturbances of blood circulation it is not observed, but load of walls of vessels increases and the aortic aneurysm can be created.

At serious deformation of an aortic arch there can be a squeezing of a gullet, trachea and nervous trunks. For treatment of deformation of an aortic arch the special medicamentous course with the subsequent surgical intervention is appointed.

Aortic arch diseases

Basic diseases of an aortic arch are aneurism and a hypoplasia.

Aneurism of an aortic arch is atherosclerotic or traumatic defeat of vessels. Symptoms of aneurism of an aortic arch are defeats of vessels of heart and a brain, a headache, a pain syndrome in a thorax, an asthma, strong pulsing in a thorax, paresis of a recurrent nerve.

For diagnosis of aneurism the radiographic research and an aortografiya which allows to establish extent of change of a wall of an aorta is conducted. Aneurism of an aortic arch is treated by means of operational prosthetics of an aorta and its branches.

The hypoplasia of an aortic arch represents a hypotrophy of average elements of vessels of an aorta and degenerative changes of a plastic cover which lead to an aorta isthmus break.

Hormonal disturbances, inborn pathologies, genetic predisposition, disturbances of an innervation are origins of a hypoplasia of an aortic arch. The hypoplasia of an aortic arch can affect other arteries, including functioning of a renal artery.

At the serious violations caused by an aorta hypoplasia surgery is performed. After carrying out operation partial correction of heart disease and other cardiovascular diseases is carried out. Then drug treatment by glycosides and diuretics is appointed.