Interrupted aortic arch: from a singular forensic case to clinical and diagnostic cue.

Abstract

Background: Abnormalities of aortic arch include variables related to structure, location, anatomical relationships and collateral vessels. This group includes the malformation known as "interrupted aortic arch". During fetal life, oxygenated blood is provided by materno-fetal circulation and own fetal circulation.

Case report.: This work discuss of female fetus born without any vital signs at 38th week by 34-years-old primigravida affected by gestational diabetes and anemia gravidarum. Pregnancy was regular. Labor and cardiotocographic tracings were regular, natural delivery; however, at the time of umbilical cord severing the baby went into cardiocirculatory arrest. Autopsy findings were: - hypertrophied right ventricle; - no morphological changes in interventricular septum, - ascending aorta physiologically arose from the left ventricle; after the emergence of the left subclavian artery and the anonymous trunk, it suddenly stopped at cul de sac. Thoracic tract arose as a collateral branch of the pulmonary artery. In addition, Botallo duct was patent. Thus, the diagnosis of death was interruption of aortic arch resulting in cardiogenic shock and irreversible cardiovascular collapse.

Conclusion: In filed case, newborn presented "type B" interruption. Interruption manifests itself between left common carotid artery and the left subclavian artery. Descending aorta arose from the pulmonary trunk. So that, in this case, right ventricle provided systemic circulation. At delivery, with the severing of the umbilical cord and physiological closure of the Botallo ductus, acute right heart failure and shock occurred. This work aims to be a cue for scientific community, in order to assist clinical and diagnostic knowledge using autopsy data with expost perspective.