case_images: PMC11072187_01
case_images: (A) The aortic angiogram demonstrated a right aortic arch with only two arch branches. (B) The LBA have no connection with the aortic arch and was delayed filled by retrograde flow from the cerebral circulation. AO, aorta; RCCA, right common carotid artery; RSA, right subclavian artery; LCCA, left common carotid artery; LSA, left subclavian artery; white line: The distance between the LBA and AO is 24.71 millimeters.
case_images: fcvm-11-1381222-g001.jpg
case_images: PMC11072187_01_fcvm-11-1381222-g001.jpg
case_images: F1
case_images: The LBA have no connection with the aortic arch and was delayed filled by retrograde flow from the cerebral circulation (Figure 1).
case_images: (A) The LBA was connected to the main pulmonary artery via the left ligamentum arteriosum. (B) A pedicle flap was created in the anteriolateral wall of the ascending aorta. The aortic flap was turned upward and anastomosed with the posterior wall of the LBA. (C) A bovine pericardial patch was used as the anterior wall to connect the aortic arch with the LBA. AO, aorta; RCCA, right common carotid artery; RSA, right subclavian artery; LCCA, left common carotid artery; LSA, left subclavian artery; DA, ductus arteriosus; LBA, left brachiocephalic artery. yellow arrow: a pedicle flap of the ascending aorta. red arrow: a bovine pericardial patch.
case_images: fcvm-11-1381222-g002.jpg
case_images: PMC11072187_01_fcvm-11-1381222-g002.jpg
case_images: F2
case_images: During the operation, we found that the LBA was connected to the main pulmonary artery via the left ligamentum arteriosum (Figure 2). The aortic flap was turned upward and anastomosed with the posterior wall of the LBA, and a bovine pericardial patch was used as the anterior wall to connect the aortic arch with the LBA (Figures 2, 3).
case_images: (A) A pedicle flap was created in the anteriolateral wall of the ascending aorta. The aortic flap was turned upward and anastomosed with the posterior wall of the LBA. (B) A bovine pericardial patch was used as the anterior wall to connect the aortic arch with the LBA. AO, aorta; RCCA, right common carotid artery; RSA, right subclavian artery; LCCA, left common carotid artery; LSA, left subclavian artery.
case_images: fcvm-11-1381222-g003.jpg
case_images: PMC11072187_01_fcvm-11-1381222-g003.jpg
case_images: F3
case_images: The aortic flap was turned upward and anastomosed with the posterior wall of the LBA, and a bovine pericardial patch was used as the anterior wall to connect the aortic arch with the LBA (Figures 2, 3).
case_images: Postoperative computed tomographic angiography showed that the reconstructed LBA was patent. AO, aorta; LCCA, left common carotid artery; LSA, left subclavian artery; LBA, left brachiocephalic artery.
case_images: fcvm-11-1381222-g004.jpg
case_images: PMC11072187_01_fcvm-11-1381222-g004.jpg
case_images: F4
case_images: Postoperatively, the patient had good left radial artery pulse, and computed tomographic angiography showed that the reconstructed LBA was patent (Figure 4).