Arteria lusoria: A rare cause of tracheal compression

2018 ◽  
Vol 69 (2) ◽  
pp. 120-121
Author(s):  
Ana Nóbrega-Pinto ◽  
Isabel Carvalho ◽  
Cecília Almeida-Sousa
2018 ◽  
Vol 69 (2) ◽  
pp. 120-121 ◽  
Author(s):  
Ana Nóbrega-Pinto ◽  
Isabel Carvalho ◽  
Cecília Almeida-Sousa

2013 ◽  
Vol 121 (03) ◽  
Author(s):  
M Pasieka ◽  
S Thavarajah ◽  
M Adamzik ◽  
A Paul ◽  
F Weber ◽  
...  

2020 ◽  
Vol 73 (2) ◽  
pp. 61-68
Author(s):  
Csaba Dzsinich ◽  
Gábor Darabos ◽  
László Székely ◽  
László Barta ◽  
Gábor Vallus ◽  
...  

Absztrakt: Az aortaív fejlődési rendellenességei az újszülöttek 1-2%-ában fordulnak elő. E betegcsoportban a bal oldali aortaívből eredő jobb arteria subclavia incidenciája 0,7–2%, míg a jobb oldali aortaívből eredő bal arteria subclavia 0,4%-ra tehető. A rendellenes eredésű arteria subclavia – arteria lusoria – okozta panaszok vagy az oesophagus, vagy a trachea compressiójából, vagy azok kombinációjából származnak. Ritka szövődményként a Kommerell diverticulum B típusú aortadissectióval vagy törmelékes bennékének elsodródásával felső végtagi embolisatiót okozhat. Dolgozatunkban 5 eset ismertetését adjuk közre. Egy beteg felső végtagi embolisatióval, 2 beteg akut B típusú aortadissectióval került észlelésre. Egy beteget krónikus I. típusú thoracoabdominalis aneurysma miatt operáltunk, akinél B típusú aortadissectio állumenének thrombotizált aneurysmáját találtuk, ami Kommerell diverticulum thrombosissal társult. Egy betegünkben jobb oldali aortaívből eredő bal arteria lusoriát transponáltunk a carotis communisba. Évekkel később a centralis csonk növekedő aneurysmája miatt kellett beavatkoznunk. Sternotomiából végzett debranching után thoracalis stentgraft-implantatiót végeztünk.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Keon Young Park ◽  
Kevin C. Janek ◽  
Joshua L. Hermsen ◽  
Petros V. Anagnostopoulos ◽  
Hau D. Le

Abstract Introduction Congenital single lung (CSL) is a rare condition, and symptomatic patients often present with respiratory distress or recurrent respiratory infection due to mediastinal shift causing vascular or airway compression. Aberrant right subclavian artery (ARSA) is another rare congenital anomality that can lead to tracheal or esophageal compressions. There is only one other case of concurrent presentation of CSL and ARSA reported, which presented unique challenge in surgical management of our patient. Here we present a step-wise, multidisciplinary approach to manage symptomatic CSL and ARSA. Case presentation An infant girl with a prenatal diagnosis of CSL developed worsening stridor and several episodes of respiratory illnesses at 11 months old. Cross-sectional imaging and bronchoscopic evaluation showed moderate to severe distal tracheomalacia with anterior and posterior tracheal compression resulting from severe mediastinal rotation secondary to right-sided CSL. It was determined that her tracheal compression was mainly caused by her aortic arch wrapping around the trachea, with possible additional posterior compression of the esophagus by the ARSA. She first underwent intrathoracic tissue expander placement, which resulted in immediate improvement of tracheal compression. Two days later, she developed symptoms of dysphagia lusoria due to increased posterior compression of her esophagus by the ARSA. She underwent transposition of ARSA to the right common carotid with immediate resolution of dysphagia lusoria. As the patient grew, additional saline was added to the tissue expander due to recurrence in compressive symptoms. Conclusions Concurrent presentation of CSL and ARSA is extremely rare. Asymptomatic CSL and ARSA do not require surgical interventions. However, if symptomatic, it is crucial to involve a multidisciplinary team for surgical planning and to take a step-wise approach as we were able to recognize and address both tracheomalacia and dysphagia lusoria in our patient promptly.


2017 ◽  
Vol 06 (01) ◽  
pp. e15-e17 ◽  
Author(s):  
Mina Rouman ◽  
Alexander Petrovitch ◽  
Eva-Maria Gey ◽  
Thomas Kuntze

Background An aberrant right subclavian artery (RSA) or arteria lusoria is the most common congenital abnormality of the aortic arch with an incidence of 0.3 to 3.0%. Case Description We report a case of a perforated aneurysmal aberrant RSA, managed using a hybrid approach. Conclusion In emergency cases with acute bleeding, we recommend an endovascular approach to avoid the lethal sequel of arterial leakage. Whenever possible, the pulsatile blood flow to the right arm should be restored. Management should be tailored to the nature of the aneurysmal aberrant RSA, patient's comorbidities, and concomitant lesions.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P174
Author(s):  
Mark T Agrama

Objectives Evaluate the effects of total thyroidectomy for euthyroid goiter causing tracheal compression on the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Demonstrate a relationship between tracheal compression and OSA. Methods A retrospective study of 8 patients with euthyroid goiter causing tracheal compression who had moderate or severe OSA. Between January 2004 and December 2007, 8 patients with these conditions were treated in a community hospital by the author. At least 1 compressive symptom (dysphagia, dyspnea, and/or orthopnea) was reported by all patients. Computed tomography of the neck and chest was used to confirm the extent of goiter and tracheal compression. OSA was confirmed with preoperative polysomnography. Total thyroidectomy was performed. Postoperative polysomnography was obtained after 90 days. Outcome measures were changes in compressive symptoms and AHI using paired t test. Results All 8 patients reported symptomatic control of compressive symptoms after thyroidectomy. 7 of 8 patients demonstrated postoperative improvement of AHI. The mean postoperative AHI decreased significantly from 52.1 to 36.6 (P < 0.05). Conclusions Total thyroidectomy for goiter causing tracheal compression can significantly improve symptoms and AHI in those patients who have OSA. Evaluation of patients with OSA should include screening for tracheal compression from goiter.


2018 ◽  
Vol 69 (4) ◽  
pp. 422-429
Author(s):  
Hedyeh Ziai ◽  
Nicole L. Lebo ◽  
Ania Z. Kielar ◽  
Michael J. Odell

Purpose To determine whether an ultrasonography (US)-defined thyroid volume can accurately predict substernal extension or tracheal narrowing. Methods After research ethics approval, we identified patients with thyroid nodules investigated with both US and computed tomography (CT). Reviewers assigned scores for both substernal extension and tracheal compression on CT using pre-established classification systems. Statistical analysis with receiver operating characteristic curve analysis was performed to find the US-determined thyroid volume thresholds that correlated with each substernal extension and tracheal compression. Results This study included 120 patients (mean age 63.4 years; SD ± 15.9; 67% female). Thirty-five patients (29%) had substernal extension. The mean US total thyroid gland volume in patients with and without substernal extension were 92.4 and 37.6 cm3, respectively ( P < .001). 86% of patients with substernal extension had tracheal narrowing vs. 27% of patients without substernal extension ( P < .0001). A cutoff dominant gland volume of ≥37.5 cm3 showed 83% sensitivity and 79% specificity for substernal extension (area under the curve [AUC] = 0.84). A total thyroid gland volume threshold of ≥37.8 cm3 showed 89% sensitivity and 87% specificity for any degree of tracheal narrowing (AUC = 0.90). Conclusions This study suggests that US volumes may be used as a predictor to identify those patients with thyroid enlargement who are most at risk of substernal extension and tracheal compression and who may benefit from preoperative CT imaging for optimal surgical and anesthetic planning.


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