A systematic segmental analysis of cardiovascular anatomy is
essential for optimal management of patients with congenital
heart disease (CHD). Understanding cardiac anatomy is integral
to the pediatric cardiology training, while it is much less
discussed among adult cardiologists and echocardiographers.
Nonetheless, it is not uncommon for an adult cardiologist and
echocardiographers to encounter a patient with unrepaired or
repaired CHD. Therefore, it is important to understand the
basics of sequential segmental approach. Besides, the uniform
use of such an approach helps in easy communication among
team members managing a patient with suspected CHD.
For obvious reasons, while most anatomic details are well
delineated on echocardiography, it is not always possible to
demonstrate all aspects of cardiac anatomy and necessitate the
use of other imaging modalities. In this article, we provide a
brief description of the sequential segmental approach to cardiacanatomy with an emphasis on echocardiographic evaluation.
Sequential segmental approach to congenital heart diseaseRamachandra Barik
The sequential segmental approach is essential for better understanding of cardiac anatomy in normal and malformed hearts. It is based on
a detailed analysis of the three main cardiac segments, namely atria, ventricles, and great vessels, and the two connecting segments, namely
atrioventricular and ventriculoarterial connections. Each segment is systematically defined based purely on its morphological characteristics.
In most cases, echocardiography is sufficient, but some cases necessitate the use of other imaging modalities. Systematic identification of
different segments, connections, and their abnormalities helps in making an accurate diagnosis of congenital heart disease (CHD). This review
provides a brief description of the sequential segmental approach for detecting CHD on echocardiography
A systematic segmental analysis of cardiovascular anatomy is
essential for optimal management of patients with congenital
heart disease (CHD). Understanding cardiac anatomy is integral
to the pediatric cardiology training, while it is much less
discussed among adult cardiologists and echocardiographers.
Nonetheless, it is not uncommon for an adult cardiologist and
echocardiographers to encounter a patient with unrepaired or
repaired CHD. Therefore, it is important to understand the
basics of sequential segmental approach. Besides, the uniform
use of such an approach helps in easy communication among
team members managing a patient with suspected CHD.
For obvious reasons, while most anatomic details are well
delineated on echocardiography, it is not always possible to
demonstrate all aspects of cardiac anatomy and necessitate the
use of other imaging modalities. In this article, we provide a
brief description of the sequential segmental approach to cardiacanatomy with an emphasis on echocardiographic evaluation.
Sequential segmental approach to congenital heart diseaseRamachandra Barik
The sequential segmental approach is essential for better understanding of cardiac anatomy in normal and malformed hearts. It is based on
a detailed analysis of the three main cardiac segments, namely atria, ventricles, and great vessels, and the two connecting segments, namely
atrioventricular and ventriculoarterial connections. Each segment is systematically defined based purely on its morphological characteristics.
In most cases, echocardiography is sufficient, but some cases necessitate the use of other imaging modalities. Systematic identification of
different segments, connections, and their abnormalities helps in making an accurate diagnosis of congenital heart disease (CHD). This review
provides a brief description of the sequential segmental approach for detecting CHD on echocardiography
An overview of the normal embryological process of development of the Aortic arch and the clinically relevant anomalies of the aortic arch development. Ideal for Cardiology Fellows.
The typical textbook descripfion of Ebstein’s anomaly of the heart usually singles out and emphasizes the downward displacement of septal and posterior leaflets of the tricuspid valve. An anatomic reappraisal of this uncommon anomaly suggests that other structural abnormalltles of Import should be equally stressed. Among the 15 well preserved autopsy spec- imens in this series, enlargement of the rlght atrloventrkular (A-V) junction and malalignment of the giant and sometimes muscularized anterior leaflet of the tricuspid valve were consistently found. In addltion, massive an- eurysmal dilation of the right ventricle was present in almost two thirds (9 of 15) of the hearts. Our observations rake the posslblllty that abnormal embryonic development of the right A-V junction may be the primary event that leads to malformation of the tricuspid valve apparatus.
The conotruncus comprises collectively two myocardial subsegments, the conus and the truncus.
Conus is the myocardial segment between ventricle and semi lunar valves which gives rise to sub arterial coni.
Truncus is the fibrous segment between semi lunar valves and aortic sac which gives rise to great arteries.
The term “complete transposition of the great
arteries” (TGA) is traditionally used to name congenital
heart defects (CHDs) that are characterized by discordant
ventriculo-arterial connections. In such a situation, the
morphologically right ventricle is abnormally connected
to the ascending aorta while the morphologically left
ventricle is abnormally connected to the pulmonary trunk.
In the majority of cases, discordant ventriculo-arterial
connections are associated with parallel (non-spiraling)
arrangement of the arterial trunks, suggesting that the
condition may have resulted from abnormal development
of the outflow tract of the embryonic heart.[1,2] Parallel
arrangement (non-spiraling) of the great arterial trunks,
however, does not necessarily indicate the presence of
TGA. For example, a few cases have been reported in
which TGA occurred with normal spiraling of the arterial
trunks. Furthermore, in cases of CHDs with a solitary
ventricle of indeterminate morphology (“univentricular”
hearts), parallel great arterial trunks cannot be connected
in a discordant fashion to the ventricle since neither a
morphologically right nor a morphologically left ventricle
exists. Parallel arrangement (non-spiraling) of the great
arterial trunks, thus, should not be named TGA but
rather “malposition of the great arterial trunks”
An overview of the normal embryological process of development of the Aortic arch and the clinically relevant anomalies of the aortic arch development. Ideal for Cardiology Fellows.
The typical textbook descripfion of Ebstein’s anomaly of the heart usually singles out and emphasizes the downward displacement of septal and posterior leaflets of the tricuspid valve. An anatomic reappraisal of this uncommon anomaly suggests that other structural abnormalltles of Import should be equally stressed. Among the 15 well preserved autopsy spec- imens in this series, enlargement of the rlght atrloventrkular (A-V) junction and malalignment of the giant and sometimes muscularized anterior leaflet of the tricuspid valve were consistently found. In addltion, massive an- eurysmal dilation of the right ventricle was present in almost two thirds (9 of 15) of the hearts. Our observations rake the posslblllty that abnormal embryonic development of the right A-V junction may be the primary event that leads to malformation of the tricuspid valve apparatus.
The conotruncus comprises collectively two myocardial subsegments, the conus and the truncus.
Conus is the myocardial segment between ventricle and semi lunar valves which gives rise to sub arterial coni.
Truncus is the fibrous segment between semi lunar valves and aortic sac which gives rise to great arteries.
The term “complete transposition of the great
arteries” (TGA) is traditionally used to name congenital
heart defects (CHDs) that are characterized by discordant
ventriculo-arterial connections. In such a situation, the
morphologically right ventricle is abnormally connected
to the ascending aorta while the morphologically left
ventricle is abnormally connected to the pulmonary trunk.
In the majority of cases, discordant ventriculo-arterial
connections are associated with parallel (non-spiraling)
arrangement of the arterial trunks, suggesting that the
condition may have resulted from abnormal development
of the outflow tract of the embryonic heart.[1,2] Parallel
arrangement (non-spiraling) of the great arterial trunks,
however, does not necessarily indicate the presence of
TGA. For example, a few cases have been reported in
which TGA occurred with normal spiraling of the arterial
trunks. Furthermore, in cases of CHDs with a solitary
ventricle of indeterminate morphology (“univentricular”
hearts), parallel great arterial trunks cannot be connected
in a discordant fashion to the ventricle since neither a
morphologically right nor a morphologically left ventricle
exists. Parallel arrangement (non-spiraling) of the great
arterial trunks, thus, should not be named TGA but
rather “malposition of the great arterial trunks”
The basic fundamental plan of the aortic arches is similar in different vertebrates during embryonic stages.
But in adult the condition of the arrangement is changed either being lost or modified considerably.
The number of aortic arches is gradually reduced as the scale of evolution of vertebrates is ascended.
The embryonic aortic arches were basically six pairs.
But with progressive evolution , there has been consequent reduction in numbers of aortic arches.
In the basic pattern the major arterial channels consists of
A ventral aorta emerging from the heart and passing forward beneath the pharynx
A dorsal aorta paired above the pharynx and passing caudal above the digestive tract.
Six pairs of aortic arches connecting ventral aorta to with the dorsal aorta.
1st aortic arch= Mandibular aortic arch
2nd Aortic arch= hyoid aortic arch
3rd ,4th ,5th and 6th aortic arches in case of aquatic animal , known as branchial aortic arches.
Variations In Branching Pattern Of Coeliac Trunkiosrjce
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
An unusual origin of brachiocephalic and left common carotid arteries 2018
1. International Journal of Health Sciences & Research (www.ijhsr.org) 292
Vol.8; Issue: 9; September 2018
International Journal of Health Sciences and Research
www.ijhsr.org ISSN: 2249-9571
Case Report
An Unusual Origin of Brachiocephalic and Left Common Carotid Arteries
as a Common Trunk from the Arch of Aorta: A Case Report
Jyoti Umarji1
, Uma B Gopal2
, Srikanth Vislavath1
1
Post Graduate Scholar, 2
Professor Department of Rachana Sharir,
Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India
Corresponding Author: Jyoti Umarji
ABSTRACT
The variations in branching pattern of arch of aorta are likely to occur as a result of the altered
development of certain branchial arch arteries during the embryonic period. The incidence of origin of
left common carotid artery and brachiocephalic artery from a single trunk is estimated as 7.2-21%.
This kind of variations in branching pattern may present with non-specific symptoms such as
dyspnoea, dysphagia, intermittent claudication. This case highlights about Brachiocephalic and left
common carotid artery arose from a common trunk on the arch of the aorta in a male cadaver. The
knowledge of such variations is important for interventional radiologist and surgeons to perform safe
and effective thoracic surgeries.
Keywords: Arch of aorta, Brachiocephalic, Left common carotid artery, Common trunk.
INTRODUCTION
Aorta is the largest artery in the
body, which distributes blood to the entire
body through its branches. It begins from
the left ventricle of heart at the aortic orifice
with an approximate diameter of 3cm. For
convenience of description, it is divided into
ascending aorta, the arch of aorta and the
descending aorta. The arch of aorta is a
continuation of ascending aorta, begins at
the level of upper border of second right
sternocostal joint. It has three classical
branches arise from the convex aspect of
arch and supply blood to the head, neck and
to the upper limbs. The variations in the
aortic arch branching pattern are well
known as they may arise from the beginning
of the arch or the upper part of ascending
aorta. The distance between these origins
varies, the most frequent being
approximation of the left common carotid
artery to the brachiocephalic trunk. Primary
branches from the aortic arch may be
reduced to one but more commonly two. [1,2]
The variations in these branches are likely
to occur as a result of the altered
development of certain branchial arch
arteries during the embryonic period. [3]
The
origin of left common carotid artery and
brachiocephalic artery from a single trunk
having a prevalence of 7.2-21%. [4]
This anomaly assumes some
importance in the adult as well as in
children, as a cause of variation in position
of artery and improper blood flow to brain.
Sometimes may be associated with a higher
incidence of cerebrovascular disorders. [5]
CASE REPORT
The present report describes
variation in branching pattern of the aortic
arch identified in a 70-year-old male
cadaver during routine dissection of
undergraduate students in the Department of
Anatomy, Sri Dharmasthala
Manjunatheshwara College of Ayurveda
2. Jyoti Umarji et.al. An Unusual Origin of Brachiocephalic and Left Common Carotid Arteries as a Common
Trunk from the Arch of Aorta: A Case Report
International Journal of Health Sciences & Research (www.ijhsr.org) 293
Vol.8; Issue: 9; September 2018
and Hospital, Hassan. The Cadaver belongs
to South India, Karnataka region procured
through voluntary body donation
programme. During routine dissection of
thoracic cavity, in particular the pericardium
and the heart it was noted that there was an
unusual origin of brachiocephalic and left
common carotid artery as a single trunk
from the arch of aorta on right side of
midline. The diameter of common trunk was
about 2.2 cm and length was 1.7 cm. The
left subclavian artery was seen as a separate
branch arising slightly left to this trunk and
had normal course. The position of
ascending aorta, arch of aorta and
descending aorta were normal and no other
variants noted.
The following photographs show
two branch pattern of aortic arch (AA).
Common trunk (CT) is arising from the AA
& dividing into brachiocephalic trunk
(BCT) and left common carotid artery
(LCCA). Left subclavian artery (LSA) is
arising next to CT.
Figure: a) Anterior view b) Posterior view c) Common trunk
DISCUSSION
Aorta is the largest artery in the
body, which arises from the left ventricle of
heart at the aortic orifice with an
approximate diameter of 3cm. It is the major
artery which receives oxygenated blood
from left ventricle and distributes blood to
the entire body through its branches. For
convenience of description, it divided into
ascending aorta, arch of aorta and the
descending aorta. The arch of aorta is the
continuation of ascending aorta at the level
of upper border of 2nd right sternocostal
joint, lies in superior mediastinum. It arches
superiorly, posteriorly and to the left and
then inferiorly makes curved arch. This arch
ascends anterior to the right pulmonary
artery and bifurcation of trachea, reaching
its apex at the left side of the trachea and
oesophagus. The arch descends posterior to
left lung root beside the T4 vertebra. It ends
by becoming thoracic aorta posterior to 2nd
left sternocostal joint. The usual branches
from the arch of aorta are the
brachiocephalic trunk, left common carotid
artery and left subclavian artery.
The brachiocephalic trunk is the first
and largest branch of the arch of the aorta,
arises posterior to manubrium, where it
anterior to trachea and posterior to
brachiocephalic vein. This trunk ascends
superolaterally to reach the right side of the
trachea and the right sternoclavicular joint,
then divides into right common carotid and
right subclavian arteries. The left common
carotid artery arises from the arch, slightly
to the left of the brachiocephalic artery, and
as it ascends it is nearer to the posterior
surface of manubrium sterni and passes
posterolateral to the left margin of trachea.
Then it enters into neck by passing deep to
the left sternoclavicular joint at the level of
T2 vertebra, at the level of C4 vertebrae it
bifurcates into left internal carotid and left
3. Jyoti Umarji et.al. An Unusual Origin of Brachiocephalic and Left Common Carotid Arteries as a Common
Trunk from the Arch of Aorta: A Case Report
International Journal of Health Sciences & Research (www.ijhsr.org) 294
Vol.8; Issue: 9; September 2018
external carotid arteries. The left subclavian
artery arises from the aortic arch behind the
left common carotid artery. It runs upwards
along the left side of the trachea and the
oesophagus, then enters the root of the neck
at the level of left sternoclavicular joint and
continues further as axillary artery at the
level of outer border of 1st rib. [6,7]
Developmental anatomy of arch of aorta
and its branches
The variations in the aortic arch
branching pattern are result from the
deletion of chromosome 22q11 during
development of certain pharyngeal arch
arteries in embryological growth. [8]
The
Pharyngeal arches are formed by a series of
mesodermal thickening in the wall of the
cranial most part of the foregut during 4th to
6th weeks of development; each arch
receives its own artery. These arteries, aortic
arches are arising from the most distal part
of the truncus arteriosus of aortic sac. The
six pairs of aortic arches are a series of
vessels that connect on each side of the
aortic sac with the corresponding dorsal
aorta. At a later developmental stage, the
aortic arches are both reduced in number
and extensively transformed, and finally an
asymmetric blood distributing system is
formed. The first and second aortic arches
largely disappear by the time third to sixth
arches develop. The left limb of the aortic
sac normally forms the part of the arch of
aorta that intervenes between the origin of
the brachiocephalic trunk and the left
common carotid artery. Brachiocephalic
artery is derived from the right horn of the
aortic sac and left Subclavian artery is from
left 7th cervical intersegmental artery. [9]
The branching pattern observed in this case
results from slower growth of the ventral
aortic roots between arches III-IV, allowing
fusion between the brachiocephalic and left
common carotid branches. [10]
The variations in the aortic arch
branching pattern were well known as they
may arise from the beginning of the arch or
the upper part of ascending aorta. [11]
The
reported variations in the aortic arch
branching pattern includes left common
carotid artery originating from the
brachiocephalic trunk; right common carotid
artery and right subclavian artery
originating individually from the aortic arch.
Additionally, left common carotid artery
and left subclavian artery may have a
common origin in the form of the left
brachiocephalic trunk from the aortic arch.
[12]
The classical branching pattern of arch of
aorta was reported from studies as to occur
in 74%-89.4% cases in radiological
investigations and 63.5% to 77.3% in
cadaveric studies. The prevalence of present
case (the left common carotid artery arising
from BCT) is estimated from previous
studies ranges between7.2% to 21.1%. [13]
The incidence of present case branching
pattern was reported in various studies are
summarized table no 1. Edwards J E [14]
and
Kieffer E reported 10% of incidence in both
autopsy studies and large surgical series of
innominate artery disease study. [15]
Anson
and MC Vay reported 27% in 1000
cadaveric specimens, [16]
Soubhagya R et.al
found 4.8% in 62 cadavers, [17]
Ogeng’o J A
et.al reported 25.7% in 113 cadavers, [18]
Rekha and Senthikumar S reported 2.72% in
110 cadavers, [19]
Junagade B and
Mukherjee A reported 8.58% in 35 cadavers
[20]
and Zhang Y et.al was found 13.2% of
incidence among 38 specimens. [21]
Table :01. The incidence of left common carotid artery arising
from BCT in various studies.
These reports suggest that the left common
carotid artery arising from Brachiocephalic
trunk is common variation and may be
frequent in large populations.
CLASSIFICATION OF AORTIC ARCH
BRANCHES
As per the survey study conducted
by G. Vucurevic et al. in a group of 1265
S.No. Author Percentage
1 Edwards JE & Kieffer E 10%
2 Anson & MC Vay 27%
3 Soubhagya R et.al 4.8%
4 Ogeng’o J A et.al 25.7%
5 Rekha&Senthilkumar S 2.72%
6 Junagade B & Mukherjee A 8.58%
7 Zhang Y et.al 13.2%
4. Jyoti Umarji et.al. An Unusual Origin of Brachiocephalic and Left Common Carotid Arteries as a Common
Trunk from the Arch of Aorta: A Case Report
International Journal of Health Sciences & Research (www.ijhsr.org) 295
Vol.8; Issue: 9; September 2018
patients, has reported about the
classification of branching pattern based on
their incidence. They found about 74.72%
of patients have normal vascular pattern
(type I) and remaining 25.28% are with
variations in the branching pattern of the
aortic arch and classified into type II to VIII
and a few subtypes. The Type II (2.84%)
pattern comprised a common origin of the
left common carotid and subclavian arteries.
Type III (15.56%) was related to an origin
of the left subclavian artery from the
brachiocephalic trunk. Type IV (0.55%)
included the aortic origin of both common
carotid and subclavian arteries, with the
right subclavian artery having a retro-
oesophageal course. Type V (0.24%)
included the same 4 supra-aortic branches,
which, however, arose from a double or a
right-sided aortic arch. Type VI (3.63%)
comprised the aortic origin of the left
vertebral artery, type VII (0.24%) the same
origin of the right vertebral artery, and type
VIII (2.22%) the aortic origin of the
thyroidea ima artery. This classification
summarized in table no.02. [22]
Table No:2. Classification of arch of aorta branching pattern with the incidence.
The present reporting case belongs to type
III and subtype b, which has LCCA
originate from typical BCT from a single
trunk. This kind of variation in branching
pattern of the aortic arch may cause
dyspnea, dysphagia, intermittent
claudication and may be misinterpreted in
radiological examinations. Sometimes
complications may develop during neck and
thoracic surgeries. [23]
CONCLUSION
The present observational study
highlights about types and incidence of
Brachiocephalic and left common carotid
artery arising from a single trunk of aortic
arch. The rare variations in the anatomical
branching pattern of arch of aorta and its
branches are very important for
angiography, aortic instrumentation and in
thoracic surgeries. This type of cadaveric
case reports gives better three dimensional
understanding of these vessels. The
knowledge of such variations is useful to the
cardiologists, cardiothoracic surgeons and
radiologists in various diagnostic and
therapeutic procedures.
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How to cite this article: Umarji J, Gopal UB, Vislavath S. An unusual origin of brachiocephalic
and left common carotid arteries as a common trunk from the arch of aorta: a case report. Int J
Health Sci Res. 2018; 8(9):292-296.