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Iki Adachi, MD, Rajesh Krishnamurthy, MD, David L.S. Morales, MD 

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Presentation on theme: "Iki Adachi, MD, Rajesh Krishnamurthy, MD, David L.S. Morales, MD "— Presentation transcript:

1 A double aortic arch mimicking a right aortic arch with an aberrant subclavian artery 
Iki Adachi, MD, Rajesh Krishnamurthy, MD, David L.S. Morales, MD  Journal of Vascular Surgery  Volume 54, Issue 4, Pages (October 2011) DOI: /j.jvs Copyright © 2011 Society for Vascular Surgery Terms and Conditions

2 Fig 1 a, A left anterior oblique view of a three-dimensional (3D) volume-rendered image of the vasculature shows the branching pattern of the neck vessels. There is a patent right aortic arch, with an appearance suggestive of an aberrant left subclavian artery (white arrow). However, the left common carotid artery (red arrow) is tethered and deflected posteriorly and is approximated with the left subclavian artery. b, This relationship is better appreciated on a superior thoracic inlet view of a 3D rendering of the trachea and vasculature. c, A mirror-image symmetric arrangement of the arch vessels is shown with respect to the trachea and esophagus on an axial computed tomography (CT) image at the level of the thoracic inlet. d, A coronal reformatted image from the CT image shows the circumflex course of the proximal descending thoracic aorta from right to left. The left lung has increased lucency compared with the right due to air trapping caused by proximal left main stem bronchus obstruction from the circumflex arch. Surgical clips are noted at the site of the prior ductal ligament resection. e, A 3D volume-rendered image of the airways shows severe proximal left main stem bronchial stenosis (blue arrow). A, Aorta; P, pulmonary artery; T, trachea. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

3 Fig 2 a, An intraoperative finding of an atretic left arch is denoted by the asterisk. Bronchoscopic images are shown (b) before and (c) after the division of an atretic left arch. LB, Left bronchus; RB, right bronchus. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

4 Fig 3 The hypothetical model of a double aortic arch shows the division of the left arch into four segments, a to d.2 Adapted from Ito et al.3 A, Ascending aorta; CCA, carotid artery; D, descending aorta; lda, left ductus arteriosus; P, pulmonary artery; rda, right ductus arteriosus; SCA, subclavian artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

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