Chapter 33

    These cases may present with subocclusive tracheo bronchial dysfunction. The left pulmonary artery originates from the right pulmonary artery and course between the esophagus and the trachea before reaching the left pulmonary hilus. Many times, ventilation interference results from selective compression of the right main bronchus.
    The different anomalies of the aortic arch may co-exist with:

1. Atrial septal defects (ASD) and ostium primum
2. Ventricular septal defects (VSD)
3. Patent ductus arteriosus (PDA)
4. Eisenmenger Syndrome
5. Tetralogy of Fallot
6. Tricuspid atresia
7. Transposition of the great arteries
8. Ebstein anomaly
9. Ao stenosis
10. Different types of pulmonary stenosis
11. Malformations of the aortic arch (different types)
12. Coarctation of the aorta

Type IA of atresia of the aortic valve with intact ventricular septum and atresia of the mitral valve. This is the most commonly seen aortic atresia type. In this particular case there is aortic coarctation too, which not infrequently is described in association to this malformation.

1. Aortic atresia with marked hypoplasia of the ascending aorta and atresia of the mitral valve. Ventricular septal defect is also seen. This is also known as Type II A of atresia of the aortic valve.
2. Type II B of atresia of the aortic valve with hypoplastic ascending aorta and ventricular septal defect. The mitral valve is normal.

Portrayal of different types of interruption of the aortic arch. Note the variety of possible arrangements for the origin of the main branches of the aortic arch.

Anomalous origin of the Right Subclavian Artery. Arch Aortogram.

Hypoplastic Left Heart Syndrome in an infant with severe con genital Mitral Stenosis, VSD and marked congenital stenosis of the aortic valve.