A cadaveric study of the aortic arch branching patterns

Abstract

This study was conducted to investigate the variations in the aortic arch branching patterns in the cadavers donated to the University of Texas Health at San Antonio, San Antonio, Texas. Branching patterns of vessels from the aortic arch in 56 cadavers (31 males and 25 females) were recorded after dissection of the mediastinum by the medical students. A previous meta‐analysis of variations in the adult aortic arch branching has grouped the aortic arch variants into seven different types. Our survey of cadaveric specimens revealed three of these types. The normal variant (Type 1) where the aortic arch gives rise to the brachiocephalic trunk (BT), the left common carotid (LCC) and the left subclavian (LS) arteries occurred in 69.6% (21 male and 18 female, 95% confidence interval: 56.6% to 80.2%) of cadavers. The bovine arch (BA) variant (type 2) of the aortic arch is a known congenital anomaly with both clinical and surgical significance. It is described as the common origin of the left common carotid artery (LCC) and the brachiocephalic trunk (BT) from the aortic arch. BA was present in 25% of cadavers (95% confidence interval: 15.4% to 37.8%), distributed evenly among male and female cadavers (7 male and 7 female). Type 3 variant, where the left vertebral artery (LV) was branching directly from the arch between the LCC and the left subclavian artery (LS) was noted in 5.3% (95% confidence interval: 1.3% to 15.2%) of the cadavers. Interestingly, all the cadavers found to have the type 3 variant were male. Knowledge of variations in the branching patterns of vessels from the aortic arch is essential to surgical planning to ensure optimal patient outcomes.