Right-sided aortic arch with Kommerell's diverticulum

Case contributed by Dr. Shareefa Abdulghaffar

Presentation

Shortness of breath. CT pulmonary angiography was ordered to rule out pulmonary embolism.

Patient Data

Age: 70
Gender: Female

CTPA was negative for pulmonary embolism. 

An incidental finding of a right-sided aortic arch with a bulbous enlargement at the origin of the aberrant left subclavian artery representing Kommerell's diverticulum. 

Case Discussion

Right-sided aortic arch with aberrant left subclavian artery is the most common type of right aortic arch anomaly with a prevalence of 1/2500 and represents 35-72% of right-sided aortic arch anomalies. It also represents the second most common cause of vascular rings (12-25%) after a double aortic arch. Usually, it is asymptomatic but it can be symptomatic in infancy and early childhood where they may have wheezing, stridor provoked by bronchitis and dysphagia. 

Bulbous origin of the aberrant left subclavian which represents the remnant of the embryonic left arch was first described by Burckhard Friedrich Kommerell and named after him 1.

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