Posted in Cardiology on February 23, 2014 by m.khodeer
Right aortic arch with anomalous left subclavian artery and left ductus
Aortic arch anomaly, Fig. 1
Diagram displays the more common types of aortic arch anomalies. The site of the break in the embryonic double arch producing the anomalies is depicted. (From Higgins CB., Essentials of Cardiac Radiology and Imaging)
- Right aortic arch,
- Aortic arch lying to the right of the trachea and esophagus. Its one of several aortic arch anomalies. The descending aorta runs from right to left in the middle of the thorax and passes into the abdomen on the left side. Infrequently, the right arch passes to the left side higher in the thorax so that it courses behind and compresses the trachea. This is called a retrotracheal aortic arch. There are two types of right aortic arch: mirror image and non-mirror image. Mirror image has a left innominate artery originating as the first branch of the right arch. This type is nearly always associated with cyanotic congenital heart disease, especially tetralogy of Fallot, pulmonary atresia with ventricular septal defect and truncus arteriosus. Non-mirror image right aortic arch usually has the left subclavian artery originating as the fourth branch of the aorta. It originates from the proximal descending aorta with a prominent diverticulum at the site of origin and a course behind the esophagus. Rare variant types exist such as right arch with left subclavian artery unattached to the aorta but connected to the left pulmonary artery by a ductus arteriosus. Right aortic arch with aberrant left subclavian artery produces a vascular ring with compression of the esophagus and/or airway. Non mirror image arch is infrequently associated with other congenital cardiac anomalies.