Double aortic arch

Case contributed by Mostafa Elfeky
Diagnosis certain

Presentation

Cough and dyspnea.

Patient Data

Age: 6 months
Gender: Male
ct

Complete double aortic arch is seen creating a complete vascular ring, compressing the middle thoracic trachea, creating near 70% diameter stenosis and the esophagus.

Both right and left limbs of the arch are completely developed with near symmetric caliber; no definite interruptions. The aortic branches show normal caliber and patency, the common carotid and subclavian arteries for each side.

 

Annotated image

Double aortic arch forming a complete vascular ring, compressing the middle thoracic trachea. Each side of the vascular ring gives off common carotid artery and subclavian artery.

Case Discussion

Double aortic arch is the most common symptomatic type of aortic arch variants and vascular rings. Both the trachea and esophagus are encircled. Respiratory symptoms are common in infancy. In this case, there is near equal size of both arches denoting co-dominance.

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