Successful Percutaneous Coronary Intervention in 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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Unusual Retrograde Aortic Arch Dissection During Percutaneous Coronary Intervention

Angiology ◽

10.1177/0003319706290626 ◽

2006 ◽

Vol 57 (4) ◽

pp. 501-505 ◽

Cited By ~ 9

Author(s):

Tejas M. Patel ◽

Sanjay C. Shah ◽

Alok Ranjan

Keyword(s):

Percutaneous Coronary Intervention ◽

Aortic Arch ◽

Coronary Intervention ◽

Percutaneous Coronary

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TCTAP C-158 Successful Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction with Arteria Lusoria and Severely Tortuous Descending Aorta by 5 French Guiding Catheter

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2014.02.429 ◽

2014 ◽

Vol 63 (12) ◽

pp. S163

Author(s):

Sho Torii

Keyword(s):

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

St Elevation Myocardial Infarction ◽

Descending Aorta ◽

Arteria Lusoria ◽

Percutaneous Coronary ◽

St Elevation ◽

Guiding Catheter

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Primary percutaneous coronary intervention in a patient with right internal mammary artery graft originating from arteria lusoria dextra

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1304223a ◽

2013 ◽

Vol 141 (3-4) ◽

pp. 223-227

Author(s):

Srdjan Aleksandric ◽

Sinisa Stojkovic ◽

Miloje Tomasevic ◽

Jelena Kostic ◽

Marko Banovic ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Aortic Arch ◽

Subclavian Artery ◽

Primary Percutaneous Coronary Intervention ◽

Bypass Graft ◽

Coronary Intervention ◽

Aberrant Right Subclavian Artery ◽

Percutaneous Coronary ◽

Internal Mammary

Introduction. Congenital anomalies of the aortic arch, although numerous and heterogeneous, occur in less than 1% of individuals at autopsies. Left aortic arch with an aberrant right subclavian artery, also called arteria lusoria dextra, is the most common anomaly of the aortic arch, occurring in 0.5-2.5% of individuals. Case Outline. We report the case of a 48-year-old man suffering from acute inferoposterior-wall ST elevation myocardial infarction successfully treated by primary percutaneous coronary intervention. Ten years ago, the patient had undergone coronary artery bypass graft surgery with the implantation of two arterial grafts - left and right internal mammary arteries on both left anterior descending and right coronary artery. After several attempts to canulate truncus brachiocephalicus, angiogram revealed the left aortic arch with the aberrant right subclavian artery. To our knowledge, this is the first described case of primary percutaneous coronary intervention via the aberrant right subclavian artery and right internal mammary artery graft with stent implantation in the infarct related lesion of the distal segment of right coronary artery. Subsequent 64-multidetector computed tomography confirmed the angiographic findings. Conclusion. Early recognition of congenital anomalies of the aortic arch and its great vessels, even before coronary artery bypass graft surgery, could be crucial for the urgent and successful treatment of patients with life-threatening conditions, such as ST segment elevation myocardial infarction.

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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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