Tracheotomy bleeding from an unusual tracheo-arterial fistula: involvement of an aberrant right subclavian artery

2010 ◽  
Vol 124 (12) ◽  
pp. 1333-1336 ◽  
Author(s):  
C Desvant ◽  
D Chevalier ◽  
G Mortuaire
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Assisted Ventilation ◽  
Aberrant Right Subclavian Artery ◽  
Severe Scoliosis ◽  
Arteria Lusoria ◽  
Computed Tomography Scanning ◽  
Mediastinal Vessels

AbstractIntroduction:The development of a tracheo-arterial fistula is a rare but severe complication of tracheotomy. The reported patient presented with such a fistula involving an aberrant right subclavian artery, termed an arteria lusoria, an aortic arch abnormality which is usually asymptomatic.Case report:A 30-year-old man was admitted to our institution for bleeding through his tracheotomy. He had been treated for advanced Duchenne muscular dystrophy, involving invasive assisted ventilation, since the age of 10 years. Surgical exploration and computed tomography scanning revealed a tracheo-arterial fistula involving an aberrant right subclavian artery, associated with severe scoliosis. Emergency, transient haemostasis was achieved by over-inflation of the tracheostomy tube cuff. Aneurysm ablation was successfully achieved as the result of an endovascular interventional radiology procedure.Discussion:Arteria lusoria is one of the most common aortic arch abnormalities. The occurrence of an aneurysm of this artery in a tracheotomised patient has not previously been described. In Duchenne muscular dystrophy patients, spinal deformities may result in thoracic compression, which may alter the anatomical relations of mediastinal vessels. Such deformities are slowly progressive. Thus, vigilance is required in the long term management of Duchenne muscular dystrophy patients with a tracheostomy.

scholarly journals A Rare Case of Esophageal Dysphagia in Children: Aberrant Right Subclavian Artery

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Claudia Barone ◽  
Nicolina Stefania Carucci ◽  
Claudio Romano
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Inflammatory Diseases ◽  
Vascular Anomaly ◽  
Aberrant Right Subclavian Artery ◽  
Posterior Portion ◽  
Arteria Lusoria ◽  
Esophageal Dysphagia ◽  
Extrinsic Compression ◽  
Barium Esophagogram

Dysphagia is an impairment of swallowing that may involve any structures from the mouth to the stomach. Esophageal dysphagia presents with the sensation of food sticking, pain with swallowing, substernal pressure, or chronic heartburn. There are many causes of esophageal dysphagia, such as motility disorders and mechanical and inflammatory diseases. Infrequently dysphagia arises from extrinsic compression of the esophagus from any vascular anomaly of the aortic arch. The most common embryologic abnormality of the aortic arch is aberrant right subclavian artery, clinically known asarteria lusoria. This abnormality is usually silent. Here, we report a case of six-year-old child presenting to us with a history of progressive dysphagia without respiratory symptoms. A barium esophagogram showed an increase of the physiological esophageal narrowing at the level of aortic arch, while at esophagogastroduodenoscopy there was an extrinsic pulsatile compression of the posterior portion of the esophagus suggesting an extrinsic compression by an aberrant vessel. Angio-CT (computed tomography) scan confirmed the presence of an aberrant right subclavian artery.

scholarly journals The Aberrant Right Subclavian Artery (Arteria Lusoria): The Morphological and Clinical Aspects of One of the Most Important Variations—A Systematic Study of 141 Reports

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Michał Polguj ◽  
Łukasz Chrzanowski ◽  
Jarosław D. Kasprzak ◽  
Ludomir Stefańczyk ◽  
Mirosław Topol ◽  
...  
Keyword(s):  
Weight Loss ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Aberrant Right Subclavian Artery ◽  
Clinical Aspects ◽  
Arteria Lusoria ◽  
Retrosternal Pain ◽  
Adjacent Structures ◽  
Kommerell’S Diverticulum ◽  
Male Subjects

The most important abnormality of the aortic arch is arguably the presence of an aberrant right subclavian artery (arteria lusoria). If this vessel compresses the adjacent structures, several symptoms may be produced. The aim of the study is to present the morphological and clinical aspects of the aberrant right subclavian artery. Three different databases searched for a review of pertinent literature using strictly predetermined criteria. Of 141 cases, 15 were cadaveric and 126 were clinically documented. The gender distribution of the subjects was 55.3% female and 44.7% male. The mean age of the patients at symptoms onset was49.9±19.4years for all patients but54.0±19.6years and44.9±18.1years for female and male subjects, respectively (P=0.0061). The most common symptoms in this group were dysphagia (71.2%), dyspnea (18.7%), retrosternal pain (17.0%), cough (7.6%), and weight loss (5.9%). The vascular anomalies coexisting with an arteria lusoria were truncus bicaroticus (19.2%), Kommerell’s diverticulum (14.9%), aneurysm of the artery itself (12.8%), and a right sided aortic arch (9.2%). In conclusion, compression of adjacent structures by an aberrant right subclavian artery needs to be differentiated from other conditions presenting dysphagia, dyspnea, retrosternal pain, cough, and weight loss.

scholarly journals Study on the views and methods of ultrasonic screening and diagnosis for abnormal aortic arch in infants

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinjian He ◽  
Jiaoyang Chen ◽  
Gaoyang Li
Keyword(s):  
Diagnostic Accuracy ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Coarctation Of The Aorta ◽  
Double Aortic Arch ◽  
Aberrant Right Subclavian Artery ◽  
Coincidence Rate ◽  
Aortic Arch Anomalies ◽  
Screening Sensitivity ◽  
Axis View

Abstract Background The purpose of this study was to explore echocardiographic views and methods of aortic arch anomalies in infants, so as to improve the screening sensitivity and diagnostic accuracy. Methods 140 children with abnormal aortic arch diagnosed by ultrasound in Children’s Hospital of Hebei Province from January 2014 to December 2019 were selected for retrospective analysis. All were confirmed by surgery or/and computerized tomography angiography. Series of views for aortic arch (the three-vessel and tracheal view, aortic arch short axis view, left aortic arch long axis view, aortic arch long axis continuous scan views) were performed in all cases on the basis of the routine views of echocardiography. The screening sensitivity and diagnostic coincidence rate of different echocardiographic views for aortic arch anomalies were analyzed. Results Among the 140 infants, right aortic arch were 21 cases (6/21 were accompanied by mirror branch and 15/21 were with aberrant left subclavian artery). Left aortic arch with aberrant right subclavian artery were 2 cases, and double aortic arch with both arches open were 20 cases. Double aortic arch with left arch atresia were 2 cases, and atresia of the proximal aorta with aortic arch dysplasia was 1 case. Coarctation of the aorta were 67 cases, and interruption of aortic arch were 27 cases. All the patients were correctly diagnosed except that 2 infants with interruption of aortic arch were incorrectly diagnosed as coarctation of the aorta, and 1 infant with coarctation of the aorta was misdiagnosed as interruption of aortic arch by echocardiography. The screening sensitivities of four views and four-view combination for abnormal aortic arch were 99.3, 73.6, 87.1, 99.3, and 100%; the diagnostic coincidence rates were 85.7, 27.1,66.4, 95.0%, and 97.9% respectively. On the basis of traditional left aortic long axis view, other three views had their own advantages. The screening sensitivity and diagnostic coincidence rate of four-view combination were significantly improved. Conclusions The three-vessel trachea view is simple and feasible, which is suitable for screening abnormal aortic arch. The combination of four views conduces to improving screening sensitivity and diagnostic accuracy of aortic arch abnormalities.

MR angiography of left-sided cervical aortic arch with aberrant right subclavian artery

2007 ◽  
Vol 80 (959) ◽  
pp. e260-e264 ◽  
Author(s):  
M Haliloglu ◽  
M Karcaaltincaba ◽  
B Oguz ◽  
A Celiker
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Mr Angiography ◽  
Aberrant Right Subclavian Artery

scholarly journals A rare case of obstructive supracardiac TAPVR (Total Anomalous Pulmonary Venous Return) with aberrant right subclavian artery.

2021 ◽  
Vol 28 (7) ◽  
pp. 1058-1060
Author(s):  
Fazal ur Rehman ◽  
◽  
Sabiha Khan ◽  
Waqas Ali ◽  
Asif Ali Khuhro ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Right Atrium ◽  
Venous Return ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Aberrant Right Subclavian Artery ◽  
Vertical Vein ◽  
Anomalous Pulmonary Venous Return ◽  
Tract Infections

Congenital aortic arch malformations manifest a broad-spectrum of differences and abnormalities that come from disturbed embryogenesis of branchial arches. Current case was a 10 months old baby girl with length of 69 cm (less than –3 SD) and weight of 5.5 kg (less than –3 SD). The patient had history of recurrent lower respiratory tract infections since the time of birth and failure to gain adequate weight since the time of birth. The patient has been having multiple check-ups with registered medical practitioners in the nearby locality and multiple courses of antibiotics with only partial resolution of symptoms. The 2-D echocardiogram showed her to be a case of supracardiac type of “Total Anomalous Pulmonary Venous Return (TAPVR)”. All pulmonary veins making a confluence and draining into the right atrium. Significant turbulence observed at the level of superior vena cava to right atrium junction. A level of obstruction was recorded at the junction of the confluence of pulmonary veins and the vertical vein. There was aberrant right subclavian artery from the aortic arch as its third branch with no obstruction or aneurysm formation, having retrotracheal and esophageal course.

scholarly journals An unusual origin of the right subclavian artery – arteria lusoria

2014 ◽  
Vol 27 (4) ◽  
pp. 234-236
Author(s):  
Agnieszka Mocarska ◽  
Miroslaw Szylejko ◽  
Elzbieta Staroslawska ◽  
Franciszek Burdan
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Left Vertebral Artery ◽  
Anatomical Anomaly ◽  
Arteria Lusoria ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract The aortic arch usually gives off three major arterial branches: the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The most frequently occurring developmental variations of arterial trunks origins are a joined brachiocephalic and left common carotid artery origin, the left vertebral artery branching from the aortic arch, a double aortic arch, and a change of sequence of branching arteries. The current report presents the rare asymptomatic situation of the right subclavian artery originating as the last individual branching from the aortic arch. This abnormality was accidentally discovered in a computed tomography examination of a 69-year old male patient. The examination showed that the artery went towards the neck posteriorly from the trachea. The anatomical anomaly was interpreted as being an arteria lusoria.

Diverticulum of Kommerell with Micro Aneurysm, an Aberrant Right Subclavian Artery and Ventricular Septal Defect in a 39 Years Old Female: Case Report

2021 ◽  
Author(s):  
Xiaoming Bian
Keyword(s):  
Ventricular Septal Defect ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Septal Defect ◽  
Aortic Rupture ◽  
Vascular Ring ◽  
Vascular Lesion ◽  
Aberrant Right Subclavian Artery ◽  
Successful Operation ◽  
Diverticulum Of Kommerell

Diverticulum of Kommerell is a congenital anomaly in the development of the primitive embryonic aortic vasculature resulting in either an aberrant left subclavian artery (ALSA) from a right-sided aortic arch (RSAA) or an aberrant right subclavian artery (ARSA) from a left-sided aortic arch (LSAA). Kommerell’s diverticulum (KD), is extremely rare in the general population having prevalence of 0.7–2.0 %. KD with true aneurysmal dilatation like any vascular lesion of the thoracic aorta weakens the vasculature and increases the risk of aortic rupture. Timely surgical intervention is of paramount importance in most of these cases. Variable clinical presentations in patients with KD are either a result of compression of some mediastinal organs or strangulation by the vascular ring from the aberrant subclavian artery (ASA). We report a case of a 39 years old Chinese female with a rare co-existence of a huge KD with a microaneurysm, an aberrant right subclavian artery (ARSA), and ventricular septal defect (VSD). She underwent a successful operation and all her pre-surgical symptoms disappeared.

scholarly journals Incidental finding of aberrant subclavian artery during computed tomography scan

2015 ◽  
Vol 3 (4) ◽  
pp. 162-164
Author(s):  
Mubarak Mohd Yusof ◽  
Sharini Shamsudin
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Incidental Finding ◽  
Right Aortic Arch ◽  
Aberrant Right Subclavian Artery ◽  
Computed Tomography Scan ◽  
Tomography Scan

Two cases of aberrant subclavian arteries were detected incidentally during computed tomography scan of the thorax for other medical conditions. The patients did not have weight loss or dysphagia lusoria. The origin and course of theaberrant subclavian arteries are related to the anomaly of the aortic arch. The variations of aberrant right subclavian artery with left aortic arch and aberrant left subclavian artery with right aortic arch on computed tomography are discussed.Journal of Kathmandu Medical CollegeVol. 3, No. 4, Oct.-Dec., 2014Page: 162-164

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