Aberrant right subclavian artery associated with common carotid trunk. A rare cause of vascular ring
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This study details four infant cases of a rare vascular ring involving a common carotid trunk and aberrant right subclavian artery, often causing respiratory infections and feeding issues.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Thoracic Surgery
Background:
- Vascular rings are congenital anomalies of the aortic arch.
- Incomplete vascular rings can present with diverse and subtle symptoms.
- Common carotid trunk with aberrant subclavian artery is a rare cause of vascular rings.
Purpose of the Study:
- To describe the clinical presentation and diagnostic findings in infants with a specific type of incomplete vascular ring.
- To discuss the physiopathological mechanisms underlying symptoms in these patients.
- To review the surgical management and outcomes for this rare vascular anomaly.
Main Methods:
- Retrospective review of four pediatric cases.
- Clinical data including symptoms, physical examination, and imaging were analyzed.
- Surgical intervention involved ligature and section of the aberrant right subclavian artery.
Main Results:
- All four patients (3-9 months old) presented with recurrent respiratory infections.
- Three patients exhibited failure to thrive due to esophageal compression and bronchial aspiration.
- One patient had feeding-induced dyspnea, and another presented with stridor.
Conclusions:
- A common carotid trunk with aberrant right subclavian artery is a rare cause of symptomatic incomplete vascular rings in infants.
- Early diagnosis and surgical correction are crucial for managing respiratory and nutritional complications.
- This specific vascular anomaly requires careful consideration in infants with recurrent respiratory symptoms and feeding difficulties.
Abstract:
We have reviewed four cases of incomplete vascular rings caused by the presence of a common carotid trunk from which arose both carotid arteries associated with an aberrant right subclavian artery. The patients were aged between 3 and 9 months. All patients presented with recurrent respiratory tract infections. Three patients showed signs of malnutrition and failure to thrive caused by episodes of bronchial aspiration from extrinsic compression of the oesophagus. One patient presented with dyspnoea induced by feeding and another had stridor. A common carotid trunk associated with an aberrant subclavian artery was confirmed in all cases. No other associated anomaly was observed in any patient. Ligature and section of the anomalous right subclavian artery was performed in all patients. The low incidence of this type of vascular ring, its physiopathological mechanism and surgical management are discussed.