Aortic arch replacement through a left thoracotomy for right-sided aortic arch aneurysm with complete vascular ring

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Right-sided aortic arch with aberrant left subclavian artery is the second most common vascular ring anomaly.
• Retroesophageal aortic arch aneurysms are rare and present unique surgical challenges due to limited access to the entire arch and its branches.

Observation:

• A 39-year-old patient presented with airway obstruction caused by an aneurysmal dilatation of the retroesophageal aortic arch.
• The rarity of this condition and the complex anatomy necessitated a tailored surgical strategy.

Findings:

• A staged surgical repair was successfully performed.
• The procedure involved a right-sided carotid-subclavian artery bypass followed by aortic arch replacement using hypothermic circulatory arrest via left thoracotomy.

Implications:

• This case demonstrates a feasible staged surgical approach for managing complex retroesophageal aortic arch aneurysms.
• Successful repair relieved airway obstruction, highlighting the importance of timely intervention for such rare vascular anomalies.