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[Right aortic arch with retro-esophageal component. 2 cases].
Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1979
Summary
Right-sided aortic arch with a retro-oesophageal segment is a rare, isolated finding, unlike its counterpart. It can cause subclavian steal syndrome and respiratory issues due to the aortic ring, necessitating early surgical intervention.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Right-sided aortic arch (RSAA) is a rare congenital anomaly.
- RSAA with a retro-oesophageal segment is significantly rarer than RSAA without this feature.
- Unlike RSAA without a retro-oesophageal segment, which is typically associated with congenital heart disease, the retro-oesophageal variant is often an isolated finding.
Observation:
- The left subclavian artery may arise abnormally from a posterior diverticulum.
- Stenosis at the origin of the aberrant left subclavian artery can lead to a systolic murmur or subclavian steal syndrome.
- The ligamentum arteriosum can form a complete aortic ring, potentially causing respiratory symptoms.
Findings:
- This anatomical variation can present with diverse clinical manifestations, ranging from asymptomatic cases to significant vascular and respiratory complications.
- Observed complications include subclavian steal syndrome and, in one long-term follow-up, chronic respiratory problems and late tracheal lesions.
- The clinical presentation can be variable, with symptoms appearing at different ages and with varying severity.
Implications:
- Early diagnosis and surgical intervention are crucial for managing potential complications associated with this rare aortic arch anomaly.
- Understanding the embryological basis and clinical spectrum is vital for accurate diagnosis and effective treatment planning.
- This condition highlights the importance of comprehensive cardiovascular and respiratory assessment in patients with suspected aortic arch anomalies.