Right aortic arch with aberrant left subclavian artery
Citation, DOI & case data
History of 22q11.2 deletion syndrome (DiGeorge syndrome) and perimembranous VSD presents with 3 months of dysphagia and 20kg LOW.
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Right-sided aortic arch. There is an associated aberrant left retro-esophageal subclavian artery which results in moderate compression of the esophagus, just inferior to the thoracic inlet. There is also mild narrowing of the trachea, approximately 5-10 mm above the carina, secondary to this vascular impression. Normal caliber of the ascending and descending thoracic aorta.
Congenital anomalies of the heart are uncommon and commonly associated with other congenital cardiac diseases 1.
The above case is that of a right-sided aortic arch with an aberrant left retro-esophageal subclavian artery. Right-sided aortic arch occurs in 0.05% of the population 1. Right-sided aortic arches are classified into 3 different types. Their classification is dependent on the branching pattern of the aortic arch vessels 1,2. This case is a type II right-sided aortic arch which is relatively common accounting for 39.5% of cases 3.
While often an incidental finding on imaging symptomatic patients commonly present with dysphagia due to extrinsic esophageal compression 1.
- 1. Türkvatan A, Büyükbayraktar FG, Olçer T et-al. Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol. 2009;10 (2): 176-84. doi:10.3348/kjr.2009.10.2.176 - Free text at pubmed - Pubmed citation
- 2. Kimura-Hayama ET, MeléNdez G, MendizáBal AL et-al. Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 2010;30 (1): 79-98. Radiographics (full text) - doi:10.1148/rg.301095061 - Pubmed citation
- 3. Chai OH, Han EH, Kim HT et-al. Right-sided aortic arch with the retroesophageal left subclavian artery as the fourth branch. Anat Cell Biol. 2013;46 (2): 167-70. doi:10.5115/acb.2013.46.2.167 - Free text at pubmed - Pubmed citation