“THE DEER HORN AORTIC ARCHES” EMBRYOLOGICAL BASIS AND SURGICAL IMPLICATIONS.

Elumalai Ganesh1, Chodisetty Sushma2

  1. Department of Embryology, College of Medicine, Texila American University, South America
  2. Department of Casualty and Emergency medicine, Tribhuvan University, National Medical College, Nepal

Corresponding Author: Elumalai Ganesh. Department of Embryology, College of Medicine, Texila American University, South America

ABSTRACT
Normally, the human Aortic arch branches into three great vessels, the adult archetype of the Aortic arch and its branches are formed, due to the different growth pattern of the aortic or branchial arch arteries and their associated “migration” and “merging” of their branches. The most common variance of the aortic arch, 84.8% was the anomalous aortic arch origin of the left vertebral artery (LVA). The second most common variant was the left common carotid artery (LCCA) having a common origin with the brachiocephalic trunk (BCT) or innominate artery, 25%. These unusual presentations of the Aortic arches with the Bovine or Truncus bicaroticus and in combination with the “common vertebrosubclavian
trunk (CVST)” were referred to “Deer Horn or Double Horn pattern Aortic arches”. The Deer Horn or Double Horn pattern Aortic arches are commonly regarded as normal variants. Hence, very little direct data are available until today. Recently, it was well identified as the suspicion exists with the “Deer Horn or Double Horn” pattern Aortic arches may predispose to the Thoracic Aortic Aneurysm (TAA) and Carotid Aneurysm (CA). Radiologists are advised to lookout for the Bovine trunk, Truncus bicaroticus, and the common vertebro-subclavian trunk (CVST) Aortic arches, as a precautionary effort to rule out the TAA and CA. Deer Horn or Double Horn pattern patients tend to dissect more, especially in the descending aorta and common and Carotid or Internal carotid arteries. The present study observations argue strongly that the Deer Horn or Double Horn pattern Aortic arches should not be considered a normal variant of aortic arch anatomy and through insight knowledge about these common variants. It helps understand their association with the aortic diseases, like TAA and CA development and its complications.
Keywords: Deer Horn or Double Horn aortic arch, Bovine trunk, Truncus bicaroticus, Common vertebrosubclavian trunk (CVST).
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