TheFetus.net

Case of the Week #559

Azar Farajov
Azerbaijan

Posting Dates: May 15 - May 30, 2022

28-year-old woman (G3P2), with non-contributive history, presented to our office at 19 weeks + 3 days of her pregnancy. Following images and videos show an interesting cardiac anomaly that we found during our examination.

Image 1
Image 2
Image 3
Image 4
Image 5
Image 6
Image 7
Video 1 ©2022 Azer Farajov
Video 2 ©2022 Azer Farajov
Video 3 ©2022 Azer Farajov

View the Answer Hide the Answer

Answer

Current COW represented a case of left aortic arch and right ductus arteriosus making so called "cross ribbon sign" [1].

Four-chamber-view of the heart
Image 1 Four-chamber-view of the heart
Transverse scan of the thorax at the level of the aortic arch. Ao - aorta; SVC - Superior Vena Cava
Image 2 Transverse scan of the thorax at the level of the aortic arch. Ao - aorta; SVC - Superior Vena Cava
Three-vessel-trachea view of the heart showing pulmonary artery (PA), ascending aorta (Ao), superior vena cava (SVC), descending aorta (DAo), right pulmonary artery (RPA)
Image 3 Three-vessel-trachea view of the heart showing pulmonary artery (PA), ascending aorta (Ao), superior vena cava (SVC), descending aorta (DAo), right pulmonary artery (RPA)
Three-vessel-trachea view of the heart showing pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA), ascending aorta (Ao), superior vena cava (SVC), descending aorta (DAo)
Image 4 Three-vessel-trachea view of the heart showing pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA), ascending aorta (Ao), superior vena cava (SVC), descending aorta (DAo)
Three-vessel-trachea view of the heart showing pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA) making a vascular sling around trachea and connecting to the descending aorta (DAo), ascending aorta (Ao), superior vena cava (SVC)
Image 5 Three-vessel-trachea view of the heart showing pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA) making a vascular sling around trachea and connecting to the descending aorta (DAo), ascending aorta (Ao), superior vena cava (SVC)
Color Doppler: three-vessel-trachea view - pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA) making a vascular ring around trachea and connecting to the descending aorta (DAo). Ascending aorta (Ao), superior vena cava (SVC).
Image 6 Color Doppler: three-vessel-trachea view - pulmonary artery (PA), RIGHT DUCTUS ARTERIOSUS (RDA) making a vascular ring around trachea and connecting to the descending aorta (DAo). Ascending aorta (Ao), superior vena cava (SVC).
Drawing of the "cross ribbon sign" type of vascular ring. Right ductus arteriosus (RDA), left aortic arch (LAA). LPA - left pulmonary artery, RPA - right pulmonary artery, DA - descending aorta.
Image 7 Drawing of the "cross ribbon sign" type of vascular ring. Right ductus arteriosus (RDA), left aortic arch (LAA). LPA - left pulmonary artery, RPA - right pulmonary artery, DA - descending aorta.
Drawing of the "cross ribbon sign" type of vascular ring. Right ductus arteriosus (RDA), left aortic arch (LAA). LPA - left pulmonary artery, RPA - right pulmonary artery, DA - descending aorta.
Image 8 Drawing of the "cross ribbon sign" type of vascular ring. Right ductus arteriosus (RDA), left aortic arch (LAA). LPA - left pulmonary artery, RPA - right pulmonary artery, DA - descending aorta.

References:

1. Vijayaraghavan SB, Senthil S, Latha K. Prenatal diagnosis of a rare aortic arch anomaly with left aortic arch and right ductus arteriosus: Cross ribbon sign. Indian J Radiol Imaging. 2017;27(1):70-72. doi:10.4103/0971-3026.202963

Discussion Board

Start a discussion about this case

Winners

Lusine Karapetyan Profile Pic

Lusine Karapetyan Russian Federation Physician

Umber Agarwal Profile Pic

Umber Agarwal United States Physician

Igor Yarchuk Profile Pic

Igor Yarchuk Ukraine Physician

Andrii Averianov Profile Pic

Andrii Averianov Ukraine Physician

filiz halici öztürk Profile Pic

filiz halici öztürk Turkey Physician

Halil Mesut Profile Pic

Halil Mesut Turkey Physician

lan nguyen xuan Profile Pic

lan nguyen xuan Viet Nam Physician

Ta Son Vo Profile Pic

Ta Son Vo Viet Nam Physician

Deval Shah Profile Pic

Deval Shah India Physician

Rasha Abo Almagd Profile Pic

Rasha Abo Almagd Egypt Physician

Ionut Valcea Profile Pic

Ionut Valcea Romania Physician

Halil Korkut Dağlar Profile Pic

Halil Korkut Dağlar United States Physician

Lames Ghith Profile Pic

Lames Ghith United States

Karin Tinnemeier Profile Pic

Karin Tinnemeier Germany Physician

Add bookmark Bookmarked

Menu