2. Cardiovascular 1 Flashcards
When was a duplicated SVC first reported?
McCotter 1916
What is the development of the SVC?
By week 4
- Dorsal venous system - pre-cardinal (above the heart) and post-cardinal (below the heart) - join to form the common cardinal veins which go to sinus venosus
- Double nutritional system - vitelline veins (drain yolk sac) and umbilical veins (drain from placenta to embryo)
Right common cardinal forms SVC and its tributaries
Persistence of left common cardinal - duplication of SVC
Which paper described a duplicated aortic arch?
Ikenouchi et al, 2006
What case did Ikenouchi et al, 2006 describe?
73 year old M
Hosp for bleed in thalamus
Complained of chest pain
Duplicated aortic arch
What are the 3 types of duplicated aortic arch?
R dominated - 70%
L dominated - 25%
Co-dominant - 5%
What are the possible symptoms of duplicated aortic arch? What causes these symptoms?
Resp and digestive distress
Due to vascular ring forming around trachea and oesophagus
Development of the aortic arch?
2 dorsal arteries - join with umbilical
2 ventral arteries - fuse, extend, form aortic sac, over gut tube, join heart (forming 1st aortic arch)
Week 4 - connection between heart and 1st aortic arch lengthens (tunica arteriosus)
Tunica arteriosus becomes connected to dorsal aortae via 6 pairs of aortic arches
Dorsal aortae fuse to become descending aorta - T4-L4
Persistence of distal end of right dorsal aorta - duplicated aortic arch
What did Momma et al (1991) investigate?
Correct migration of neural crest cells needed for correct vessel formation
At which vertebral level do the iliac veins commonly unite?
L5
What did the Natsis et al (2010) paper investigate?
Types of duplicated IVC
1 - same caliber trunks and pre-aortic trunk
2 - same caliber trunks but large pre-aortic trunk
3 - asymmetric trunks - R was bigger
What are the normal 4 segments of the IVC?
Hepatic
Pre-renal
Renal
Infra-renal
From which veins does the hepatic segment of the IVC arise?
Vitelline
From which veins does the pre-renal segment of the IVC arise?
Hepatic
R subcardinal
From which veins does the renal segment of the IVC arise?
Supra-subcardinal
Post- subcardinal
From which veins does the infra-renal segment of the IVC arise?
R supracardinal
What causes duplication of the IVC?
If both supracardinal veins persist
Which veins form the iliac veins?
Posterior cardinal
What did the Hashmi and Smarolf (2007) study show?
70 year old man post foot surgery
Presented SoB and cough
Bilateral pulmonary embolism
Double IVC
Which paper investigated interrupted IVC?
Hardwick et al., 2011
What did Hardwick et al., 2011 investigate?
CT showed large mass in R lung invading into very large, swollen azygos vein
IVC interrupted, azygos system became venous return
What is the prevalence of agenesis of IVC?
0.0005 - 1% of population (up to 5% of young people who present with DVT)
What is the prevalence of ICA? Which paper is this from?
<0.01%
Gil et al., 2006
What are anomalous vessels?
Either vessels that do not normally exist
Or vessels that do normally exist but are not following their usual pathway
Which paper looked at anomalous common carotid arteries?
Anangwe et al
Kenyan population - most common bifurcation at C3
