Right aortic arch with an aberrant left subclavian artery and aortic coarctation including a descending aortic aneurysm

Frantisek Sabol,Tomas Toporcer,Peter Candik,Adrian Kolesar

doi:10.1186/s13019-019-0878-y

Abstract

BackroundThe right aortic arch and aortic coarctation are rare congenital anomalies with the incidence of 0.1% and 0.03–0.04%. We present a case report of a 51-year-old woman with the right aortic arch with aberrant left subclavian artery and coarctation of the aorta with post-stenotic aneurysm.Case presentationResection of the coarctation and aneurysm with replacement by tubular prosthesis was performed on partial cardiopulmonary bypass via femoral vessels.ConclusionPartial cardiopulmonary bypass is an applicable method for ensuring the perfusion of the distal part of the body and an aberrant left subclavian artery is not a contraindication of this technique.

Highlights

Asymptomatic congenital anomalies with an incidence of 0.5–3% include left aortic arch with an aberrant right subclavian artery with or without diverticulum of Kommerell, double site ligamentum arteriosum or ductus arteriosus and left circumflex aorta [1, 2]
CoA of Right aortic arch (RAA) together confirm a persistence of the right-sided ductus arteriosus developed during the prenatal period from the distal part of Discussion In a normal situation of the left aortic arch, the right 4th primitive aortic arch forms a brachiocephalic trunk while the left 4th primitive arch converts into the definitive aortic arch
In an situation of RAA, right 4th primitive aortic arch forms the definitive RAA, the 5th primitive arches and right 4th primitive arch regress, the 3rd left arch forms the left common carotid artery and the left dorsal primitive aorta forms the diverticulum of Kommerell with an aberrant retroesophageal left subclavian artery as a result of 7th left intersegmental artery

Summary

Introduction

Asymptomatic congenital anomalies with an incidence of 0.5–3% include left aortic arch with an aberrant right subclavian artery with or without diverticulum of Kommerell, double site ligamentum arteriosum or ductus arteriosus and left circumflex aorta [1, 2]. Right aortic arch (RAA) usually comprises an aberrant left subclavian artery most commonly with retroesophageal diverticulum. It is often associated with left sided ductus arteriosus and vascular ring [1]. The thoracic aorta was X-clamped just above the aneurysm while another (distal) clamp was placed right below the aneurysm and above the aberrant left subclavian artery. CoA of RAA together confirm a persistence of the right-sided ductus arteriosus developed during the prenatal period from the distal part of

Discussion

Findings

Conclusions

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