Right cervical aortic arch with aberrant left subclavian artery

The combination of right cervical aortic arch, aberrant retroesophageal left subclavian artery originating from a Kommerell's diverticulum, and a ligamentum arteriosum, constitutes a rare form of vascular ring. Two patients aged 21 days and 54 years, who were diagnosed by multislice 3-dimensional computed tomography and magnetic resonance imaging, underwent surgical division of a vascular ring. The adult required resection of a Kommerell's aneurysm and subclavian artery reimplantation.     

Right‐sided aortic arch and Kommerell diverticulum with aberrant left subclavian artery: Preliminarily diagnosed by echocardiography

Kommerell diverticulum (KD) with aberrant left subclavian artery (ALSA) is a rare congenital variation of vascular structure. We reported a case of 3‐year‐old boy with KD and ALSA, which was preliminarily diagnosed by transthoracic echocardiography and verified by computed tomography angiography (CTA). The patient was treated successfully with KD resection and anastomosed the left subclavian artery directly to the left carotid artery under cardiopulmonary bypass. Our case illustrates that echocardiography and CTA should be used to comprehensively assess all the internal and external cardiac structures in order to determine the appropriate surgical plan.     

Association of aortic arch anomalies and subclavian artery supply disruption with neurofibromatosis

We report an 8-year-old Japanese girl with von Recklinghausen disease, who presented with aortic arch anomalies and left hemilateral oculo-otolaryngeal abnormalities including strabismus, blepharoptosis, a dysplastic external ear and hearing loss. The aortic arch anomalies including subclavian artery obstruction that appeared to be a consequence of the neurofibromatosis, and the hemilateral oculo-otolaryngeal abnormalities could be explained by disruption of the subclavian artery supply during embryogenesis.     

A rare anomaly of the aortic arch: aberrant right subclavian artery associated with common carotid trunk

With increasing use of transradial access (TRA) to perform coronary angiography, arterial anomalies of the upper extremity are more frequently encountered. We describe a patient with an aberrant right subclavian artery (RSCA) originating as the last major branch of the aortic arch, which eventually led to failure of the transradial approach. Subsequent arch aortography revealed an associated common carotid trunk. The combination of both anomalies is a rare finding and may be associated with a number of other arterial and/or mediastinal organ anomalies.     

Aortic arch dissection with an aberrant right subclavian artery: surgical treatment

Acute dissection of the aortic arch with an aberrant subclavian artery is a rare finding. This report documents the successful treatment of this unusual problem. A 56-year-old man, brought into the emergency room with severe epigastric, chest, and interscapular pain, was treated medically until stabilized. Operation was then recommended and accepted; whereupon, dissection and control of the arch vessels, including the aberrant right subclavian artery, was accomplished. At follow-up, 3 months after discharge, the patient is active, without pain, and his blood pressure is well controlled.     

Compression of undiagnosed aberrant right subclavian artery during transesophageal echocardiography probe insertion

Transesophageal echocardiography (TEE) has become an important monitoring tool for the anesthesiologist during repair of intracardiac defects. Although the incidence of reported complications associated with its use is low, one should be careful during the insertion and use of TEE probe, as it may result in potential devastating problems. We present a case of undiagnosed aberrant right subclavian artery (ARSA) that got compressed by the TEE probe during its insertion. It was noticed because of the presence of the right radial artery catheter, else it would have passed unnoticed.     

Repair of left subclavian artery and aberrant right subclavian artery aneurysms

Left subclavian artery aneurysm with an aneurysm of the aberrant right subclavian artery is a rare condition with a reported incidence of 0.13% to 1%. We report the successful surgical correction of both conditions in a 34-year-old man.     

Dysphagia lusoria caused by persistent right aortic arch with aberrant left subclavian artery and diverticulum of kommerell

Sammary It requires a high index of suspicion to make the diagnosis of dysphagia lusoria. Clinically, these adults will present with symptoms of intermittent solid food dysphagia, and a mediastinal abnormality may be seen on chest x-ray. Noninvasive imaging of the chest with either computerized tomography or magnetic resonance scanning are excellent methods for evaluating the mediastinum for solid tumors or vascular anomalies that can cause extrinsic esophageal compression. Dysphagia lusoria caused by a persistence of the right embryologic aortic arch and diverticulum of Kommerell with an aberrant left subclavian artery may be satisfactorily managed by dietary modification when the symptoms are mild.The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official policy or reflecting the views of the Army or the Department of Defense.     

Dysphagia lusoria caused by an aberrant right subclavian artery

A 36-year-old, otherwise-healthy woman with a 6-year history of progressive dysphagia underwent an esophagogram that revealed an oblique extrinsic defect with an inferior-to-superior (left-to-right) course consistent with an aberrant right subclavian artery. An aortogram confirmed the diagnosis of aberrant right subclavian artery. She underwent surgical repair, tolerated the procedure well, and was discharged home, symptom free, on postoperative day 3. We found that the right supraclavicular approach provides good exposure and avoids the morbidity of the classically described approach via a median sternotomy or thoracotomy.     

Isolated subclavian artery aneurysm: evaluation by transesophageal echocardiography

A 50-year-old man was evaluated following a motor vehicle accident. Chest X-ray showed a widened mediastinum. Transesophageal echocardiography was helpful in identifying the left subclavian artery and in demonstrating an isolated subclavian artery aneurysm. The TEE findings correlated well with the results of chest CT. Using TEE for the identification of the aortic branches in patients with chest trauma may be critical.     

Mycotic aneurysm of the root of left subclavian artery associated with aortic coarctation discovered by echocardiography

A 16‐year‐old girl was admitted with a 7‐month history of recurrent fever, weight loss of 5 kg, and general poor health status. Blood culture was positive with Streptococcus viridans. Transthoracic echocardiography established an aneurysm of the root of left subclavian artery, associated with an aortic coarctation just before the origin of the left subclavian artery with a velocity of 4.8 cm/s. Three‐dimensional echocardiography demonstrated the entire inner structure of the aneurysm. Computed tomography reconstruction confirmed the presence of aortic coarctation and mycotic aneurysm, it also revealed an aberrant right subclavian artery.