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Double aortic arch

Case contributed by Vincent Tatco
Diagnosis certain

Presentation

Patient presented with inspiratory stridor with feeding problems. CT was requested to evaluate for vascular ring.

Patient Data

Age: 5 months
Gender: Female
ct

The aorta arises from the left ventricle. The ascending aorta splits into a dominant right arch and smaller left arch which encircle the trachea and esophagus. The bilateral aortic arches unite posteriorly and form the descending aorta.

Annotated image

Volume rendered image showing double aortic with dominant right arch and hypoplastic left arch forming a vascular ring that surrounds the trachea and esophagus. 

Case Discussion

Double aortic arch is a vascular ring anomaly due to failure of regression of both the right and left fourth branchial arches, resulting to right and left aortic arches, respectively. These two arches encircle and compress the trachea and esophagus, producing respiratory distress and feeding problems.

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