Aortic dissection involving a double aortic arch with a right descending aorta

The anatomic nature of a double aortic arch is described. Reference is made to the history of the malformation. The clinical picture and radiographic findings described by various authors are discussed. Two cases are reported which demonstrate two types of double aortic arch, One, a relatively common type, had a large right arch with a retro-esophageal component and a left descending aorta; the second, a rare type, had a large left arch with a retro-esophageal component and a right descending aorta. Further, one was an infant who had symptoms of constriction whereas the other was an adult who had no symptoms referable to the double aortic arch. Analysis is made of these cases and 47 other cases reported in the literature. This analysis reveals that: 1. There is a striking correlation between the occurrence of symptoms and the age and duration of life, but there is no correlation between the occurrence of symptoms and the type of double aortic. 2. A double aortic arch in which both components are patent throughout is more likely to produce symptoms than a double aortic arch in which one component is partially obliterated. The process of obliteration does not appear to give rise to symptoms. 3. There is considerable variation in the relative sizes of the components of a double aortic arch. The right component is usually the larger; part of the left component may be obliterated. To date, no case has been reported of obliteration of part of a persistent right Component. 4. A double aortic arch occurs more commonly with a left descending aorta than with a right descending aorta. 5. It is unusual for a double aortic arch to be associated with a malformation of the heart. The association of a double aortic arch with other vascular abnormalities is less rare. The two principal problems raised by the demonstration of a retro-esophageal vessel are discussed. The first concerns the nature of the malformation; the second concerns the advisability of operation in the given individual.

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Esophagectomy in a patient with double aortic arch and right descending aorta

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492318815375 ◽

2018 ◽

Vol 27 (3) ◽

pp. 226-227 ◽

Cited By ~ 2

Author(s):

Elizabeth A Clement ◽

Bryce Laing ◽

Simon R Turner

Keyword(s):

Esophageal Cancer ◽

Aortic Arch ◽

Double Aortic Arch ◽

Descending Aorta ◽

Ivor Lewis ◽

Surgical Field ◽

Traditional Approaches ◽

Thoracoabdominal Incision ◽

Right Descending Aorta

We herein report the case of a 57-year-old man with esophageal cancer who was found to have a double aortic arch and right-sided descending aorta. Traditional approaches such as the Ivor Lewis and McKeown were excluded because the descending aorta would obscure the surgical field, and a neck anastomosis with the conduit through the ring could result in compression. We therefore opted for a left thoracoabdominal incision, allowing excellent exposure while reserving the possibility of placing the conduit substernally.

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Successful Percutaneous Coronary Intervention in a Double Aortic Arch With a Right Descending Aorta

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2018.08.032 ◽

2018 ◽

Vol 11 (22) ◽

pp. e185-e186

Author(s):

Yusuke Sato ◽

Tetsuji Morishita ◽

Hiroyasu Uzui ◽

Hiroshi Tada

Keyword(s):

Percutaneous Coronary Intervention ◽

Aortic Arch ◽

Coronary Intervention ◽

Double Aortic Arch ◽

Descending Aorta ◽

Percutaneous Coronary ◽

Right Descending Aorta

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Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies.

Heart ◽

10.1136/hrt.28.6.722 ◽

1966 ◽

Vol 28 (6) ◽

pp. 722-739 ◽

Cited By ~ 202

Author(s):

A R Hastreiter ◽

I A D'Cruz ◽

T Cantez ◽

E P Namin ◽

R Licata

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Arch ◽

Congenital Heart ◽

Right Aortic Arch ◽

Associated Anomalies ◽

Descending Aorta ◽

Right Descending Aorta

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A case report of asymptomatic long-segmental aortic dissection diagnosed by transthoracic echocardiography

10.21203/rs.2.17293/v1 ◽

2019 ◽

Author(s):

Jiwei Wang ◽

Bin Lai ◽

Cai Yao ◽

Yongbing Wu ◽

Yanna Liu

Keyword(s):

Aortic Dissection ◽

Aortic Arch ◽

Aortic Root ◽

Transthoracic Echocardiography ◽

Aortic Rupture ◽

Target Organ Damage ◽

Common Symptom ◽

Descending Aorta ◽

Left Common Iliac Artery ◽

Cardiovascular Evaluation

Abstract Background: Aortic dissection (AD) is a life-threatening disease with high mortality rate. Severe pain in chest, back or abdomen is the most common symptom. Painless, but with a variety of other symptoms, also happened in some AD patients. Asymptomatic AD is exceptionally rare and often under-recognized. Case presentation: A 51-year-old man presented to cardiovascular department accompanied with an exaggerated low DBP and widened PP when measuring routine BP. Blood pressure was 124/36 mmHg (PP 88mmHg) in his right arm and 108/32 mmHg (PP 76mmHg) in his left arm. Transthoracic echocardiography was scheduled and showed that dissection intimal flaps are visualized in the aortic root, aortic arch and descending aorta. Subsequent CT angiography (CTA) was performed and demonstrated that a long-segmental AD occurred from aortic root to left common iliac artery. The patient underwent replacement of the aortic root, ascending aorta, and aortic arch with endovascular stent-graft placement into the descending aorta. At three months of follow-up, he was asymptomatic and with no signs of target organ damage. Conclusions: A careful TTE scan is particularly important for asymptomatic AD patient because it most likely as a routine imaging technique used for cardiovascular evaluation. If miss-diagnosed and under-recognized by clinician, untreated patients with prolonged dissection will become highly susceptible to an aortic rupture or ischemia to organs and leads to mortality.

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Surgical Management of Right Aortic Arch Obstruction Associated With Rare Form of Vascular Ring

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135119885893 ◽

2020 ◽

Vol 11 (2) ◽

pp. 222-225

Author(s):

Evgeny V. Krivoshchekov ◽

Frank Cetta ◽

Oleg A. Egunov ◽

Evgenii A. Sviazov ◽

Valeriy O. Kiselev ◽

...

Keyword(s):

Aortic Arch ◽

Surgical Management ◽

Rare Case ◽

Vascular Ring ◽

Right Aortic Arch ◽

Rare Form ◽

Descending Aorta ◽

Arch Obstruction ◽

Right Descending Aorta

This clinical case demonstrated surgical management for a rare case of vascular ring associated with an elongated and kinked aortic arch and a right descending aorta in a ten-year-old male using an extra-anatomic bypass grafting method and dividing the vascular ring. Computer tomography performed at six-month follow-up showed a favorable surgical outcome.

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Left aortic arch with right descending aorta and severe coarctation: an unusual “vascular clamp” with airway compression

Cardiology in the Young ◽

10.1017/s1047951118000665 ◽

2018 ◽

Vol 28 (8) ◽

pp. 1056-1058

Author(s):

Ronak Sheth ◽

Roy Varghese ◽

Kothandam Sivakumar

Keyword(s):

Aortic Arch ◽

Clinical Presentation ◽

Main Bronchus ◽

Left Main Bronchus ◽

Left Main ◽

Descending Aorta ◽

Airway Compression ◽

Rare Congenital Anomaly ◽

Aortic Obstruction ◽

Right Descending Aorta

AbstractLeft aortic arch with right descending aorta is a rare congenital anomaly. We describe the clinical presentation of this unusual anomaly associated with cardiorespiratory compromise from severe aortic obstruction and left main bronchus compression. The anatomical peculiarities, embryological basis, and surgical solutions are presented.

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