Abnormalities associated with aberrant right subclavian arteries-a case report

Area of Science:

• Cardiovascular Surgery
• Vascular Anatomy
• Surgical Case Reports

Background:

• Aberrant right subclavian artery (ARSA) is a congenital anomaly occurring in 0.5-2% of the population.
• While often asymptomatic, ARSA can lead to progressive dysphagia (dysphagia lusoria) due to esophageal compression.
• Surgical approach for ARSA correction depends on factors like aneurysmal involvement, urgency, and surgeon expertise.

Observation:

• A 33-year-old male presented with a 3-year history of severe dysphagia, managing only liquids.
• Barium swallow revealed extrinsic posterior esophageal compression, and angiography confirmed an ARSA with a common origin of carotid arteries.
• Surgical intervention involved a right supraclavicular approach with artery transposition and reimplantation.

Findings:

• The aberrant right subclavian artery was successfully mobilized behind the esophagus and reimplanted into the right common carotid artery.
• An associated aberrant right thoracic duct was identified and ligated during surgery.
• Literature review identified associated anomalies: nonrecurrent laryngeal nerve, common carotid origin, aberrant vertebral artery, coarctation, right thoracic duct, and right aortic arch.

Implications:

• Awareness of ARSA and its associated anomalies is crucial for surgical planning and successful management of dysphagia lusoria.
• Transposition and reimplantation of the aberrant artery can effectively relieve esophageal compression.
• Understanding these anatomical variations improves operative outcomes and patient safety in vascular anomaly correction.