Right aortic arch with subclavian steal syndrome (atresia of left common carotid and left subclavian arteries)

A case is presented which demonstrates a right aortic arch with only one functional branch arising from the arch of the aorta. This single branch represented a right innominate artery giving rise to the right common carotid and right subclavian arteries. A review of the literature has failed to reveal a similiar maldevelopment of the aortic arch. It is postulated that this patient's symptoms in the left arm were secondary to inadequate blood flow and that her cerebral symptoms were secondary to a subclavian artery steal mechanism [14–20] as a result of a congenital abnormality. The reversal of flow compatible with a subclavian artery steal syndrome was demonstrated on the preoperative anterior aortogram which revealed retrograde filling of the left vertebral and subclavian arteries.