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. 2017 Jul;36(3):278-283.
doi: 10.14366/usg.16046. Epub 2017 Feb 20.

Prenatal diagnosis of aberrant right subclavian artery in an unselected population

Mi Jin Song  1 , Byoung Hee Han  1 , Young-Hwa Kim  1 , So Young Yoon  2 , Yoo Mi Lee  1 , Hye Su Jeon  1 , Bo Kyung Park  1
Affiliations

Prenatal diagnosis of aberrant right subclavian artery in an unselected population

Mi Jin Song et al. Ultrasonography. 2017 Jul.

Abstract

Purpose: The purpose of this study was to determine the frequency of aberrant right subclavian artery (ARSA) among unselected fetuses and to evaluate its association with chromosomal abnormalities and other congenital anomalies.

Methods: In all, 7,547 fetuses (gestational age, 20 to 34 weeks) were examined using routine antenatal sonography at our institution between April 2014 and September 2015. The right subclavian artery was assessed using grayscale and color Doppler ultrasonography in the transverse 3-vessel and tracheal view, and confirmed in the coronal plane.

Results: ARSA was found in 28 fetuses (0.4%). Further, 27 of these 28 fetuses were euploid (96.4%). Trisomy 18 was the only chromosomal anomaly (3.6%) found in the study sample. ARSA was an isolated finding in 23 of the 28 cases (82.1%). In the remaining three cases (10.7%), ARSA was accompanied with extracardiac anomalies. Other cardiac defects were present in three cases (10.7%).

Conclusion: Isolated ARSA does not seem to be associated with a significantly increased risk of aneuploidy. However, the possibility of fetal karyotyping, which is a more invasive procedure, should be discussed in the light of the overall risk of the fetus.

Keywords: Aberrant right subclavian artery; Aorta, thoracic; Chromosome aberrations; Fetal echocardiography; Prenatal diagnosis; Ultrasound.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.. Comparison of color Doppler images of normal and aberrant right subclavian artery (ARSA) detected during the second trimester.
A. Color Doppler axial image shows the course of the normal right subclavian artery (arrows) anterior to the trachea (T). The typical “S” shape can be observed here. B. ARSA (arrows) arises from the junction of the aortic arch and ductus arteriosus and passes behind the trachea (T) towards the right arm. ANT, anterior; RT, right.
Fig. 2.
Fig. 2.. Color Doppler ultrasonographic coronal image showing an aberrant right subclavian artery (arrows) arising from the descending aorta (DA) with an oblique course towards the right shoulder.
RT, right.
Fig. 3.
Fig. 3.. Aneurysmal dilatation of the descending aorta and proximal portion of the aberrant right subclavian artery (ARSA) at 29 weeks of gestation.
A-C. Axial (A) and sagittal (B) images show the dilated descending aorta and proximal portion of the ARSA (arrows) with a turbulent flow (C). POST, posterior; RT, right.
See this image and copyright information in PMC

References

    1. Scala C, Leone Roberti Maggiore U, Candiani M, Venturini PL, Ferrero S, Greco T, et al. Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;46:266–276. - PubMed
    1. Chaoui R, Rake A, Heling KS. Aortic arch with four vessels: aberrant right subclavian artery. Ultrasound Obstet Gynecol. 2008;31:115–117. - PubMed
    1. Zapata H, Edwards JE, Titus JL. Aberrant right subclavian artery with left aortic arch: associated cardiac anomalies. Pediatr Cardiol. 1993;14:159–161. - PubMed
    1. Borenstein M, Minekawa R, Zidere V, Nicolaides KH, Allan LD. Aberrant right subclavian artery at 16 to 23 + 6 weeks of gestation: a marker for chromosomal abnormality. Ultrasound Obstet Gynecol. 2010;36:548–552. - PubMed
    1. Rembouskos G, Passamonti U, De Robertis V, Tempesta A, Campobasso G, Volpe G, et al. Aberrant right subclavian artery (ARSA) in unselected population at first and second trimester ultrasonography. Prenat Diagn. 2012;32:968–975. - PubMed

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