{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:31:11Z","timestamp":1786649471221,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>The catastrophic presentation, intriguing pathophysiology, and tailored management of a baby with late-presenting isolated interrupted aortic arch type B are presented herein. A 4-month-old baby presented with shock, arrested, and was resuscitated. She had severe left ventricular dysfunction, the ductus arteriosus (DA) was closed, and the ventricular septum was intact. Multiorgan dysfunction precluded emergency surgery. Inotropes were escalated, accepting upper limb hypertension, thereby facilitating collateral-dependent end-organ perfusion at higher perfusion pressures. Gradually, organ functions improved. On computerized tomography, the descending aorta was largely perfused via a sizable left vertebral artery that communicated with a dilated left subclavian artery, which was fed by the circle of Willis. Surgical correction involved extensive mobilization of the descending aorta and direct anastomosis to the arch. The postoperative course was uneventful, with recovery of LV function over 48 h. The baby is well, 7 months later. An accurate definition of the anatomy and physiology enabled stabilization and surgery.<\/jats:p>","DOI":"10.4103\/apc.apc_82_25","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T13:00:09Z","timestamp":1767272409000},"page":"392-395","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Successful salvage of late-presenting isolated type B arch interruption"],"prefix":"10.4103","volume":"18","author":[{"given":"Sakthi","family":"Saravanan","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navaneetha","family":"Sasikumar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"Srimurugan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharath","family":"Padmanabhan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaganesh","family":"Karmegaraj","sequence":"additional","affiliation":[{"name":"Sowmi Pediatric Heart Centre, Tirunelveli, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brijesh P","family":"Kottayil","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raman Krishna","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Amrita Insitute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/hrt.37.2.221","article-title":"Complete interruption of aortic arch, without persistent ductus arteriosus, in an adult","volume":"37","author":"Sharratt","year":"1975","journal-title":"Br Heart J"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1136\/hrt.36.3.313","article-title":"Interruption of aortic arch without associated cardiac abnormalities","volume":"36","author":"Judez","year":"1974","journal-title":"Br Heart J"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/0002-9149(75)90012-0","article-title":"Solitary interruption of the arch of the aorta. Clinicopathologic review of eight cases","volume":"35","author":"Dische","year":"1975","journal-title":"Am J Cardiol"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.ppedcard.2018.09.002","article-title":"Undiagnosed type B interrupted aortic arch without a patent ductus arteriosus identified during adolescence","volume":"52","author":"Burt","year":"2019","journal-title":"Prog Pediatr Cardiol"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jtcvs.2011.06.031","article-title":"A new type of aortic arch interruption without significant patent ductus arteriosus and with no ventricular septal defect","volume":"143","author":"Cazavet","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1161\/01.CIR.42.5.961","article-title":"Interruption of the aortic arch without a patent ductus arteriosus","volume":"42","author":"Morgan","year":"1970","journal-title":"Circulation"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S0022-5223(19)35154-2","article-title":"The results of a surgical program for interrupted aortic arch","volume":"96","author":"Sell","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S0022-5223(94)70387-6","article-title":"Outcomes in patients with interrupted aortic arch and ventricular septal defect. A multiinstitutional study. Congenital Heart Surgeons Society","volume":"107","author":"Jonas","year":"1994","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_82_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:54:32Z","timestamp":1786647272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_82_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_82_25","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-04-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}