Key result
Isolated aortic arch anomalies carry a ~24% rate of chromosome 22q11 deletions.
Why the study?
Chromosome 22q11 deletions are often present in patients with certain congenital cardiovascular diseases, but their frequency in isolated anomalies of aortic arch laterality and branching was unclear.
Observational (n=66)
Chromosome 22q11 deletion is present in 24% of patients with isolated anomalies of aortic arch laterality or branching, suggesting a need for deletion screening in this population.
May support targeted 22q11 screening in isolated aortic arch anomalies; leaves open impact on outcomes.
OBJECTIVES: The purpose of this study was to determine the frequency of chromosome 22q11 deletions in patients with isolated anomalies of the aortic arch and its branches. BACKGROUND: Chromosome 22q11 deletions are often present in patients with certain forms of congenital cardiovascular disease, including tetralogy of Fallot, truncus arteriosus and interruption of the aortic arch. Among patients with these anomalies, chromosome 22q11 deletion is more common in those with abnormal aortic arch laterality or branching. METHODS: We studied 66 patients with isolated anomalies of the aortic arch and no associated intracardiac defects for deletions within chromosome 22q11, using fluorescence in situ hybridization with the cosmid probe N25 (D22S75). Arch anomalies included: double aortic arch (n = 22); right aortic arch with aberrant left subclavian artery (n = 28); right aortic arch with mirror-image branching and a vascular ring formed by a left-sided ductus from the descending aorta (n = 5); right aortic arch with mirror-image branching and no vascular ring (n = 4); and left aortic arch with aberrant right subclavian artery (n = 7). In addition, four patients had a cervical aortic arch, four had aortic coarctation and six had hypoplasia/atresia of the proximal pulmonary arteries. RESULTS: Chromosome 22q11 deletions were found in 16 patients (24%) across the full spectrum of anomalies studied. Among the morphologic variables analyzed, only hypoplasia/atresia of the proximal pulmonary arteries correlated with the deletion (p = 0.03). Among patients with a double arch, the frequency of chromosome 22q11 deletion was higher in those with an atretic minor arch than it was in those with a patent minor arch (p = 0.02). CONCLUSIONS: Chromosome 22q11 deletion is associated with isolated anomalies of laterality or branching of the aortic arch in 24% of cases in our series. These findings should alert the clinician to consider deletion screening in patients with isolated anomalies of the aortic arch.
No takes yet. Share an insight, caveat, or question.
McElhinney et al. (2001) conducted an observational in Isolated anomalies of the aortic arch and its branches (n=66). Isolated anomalies of the aortic arch was evaluated on Frequency of chromosome 22q11 deletions. Isolated anomalies of the aortic arch without intracardiac defects were associated with chromosome 22q11 deletions in 24% of cases (16 of 66 patients).
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: