[Dysphagia lusoria treated by surgery].

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Congenital Anomalies

Background:

• Aberrant right subclavian artery (ARSA), or arteria lusoria, is the most frequent congenital anomaly of the aortic arch, affecting 0.5-1.8% of the population.
• Prevalence is significantly higher in patients with trisomy 21 (35%).
• ARSA arises from the aortic arch distal to other supra-aortic vessels and can be associated with other cardiovascular defects.

Observation:

• Typically located retroesophageally in over 80% of cases.
• Often asymptomatic, but can manifest later in life (post-40 years) with symptoms like dysphagia, dyspnea, or cough, particularly in women.
• Dysphagia lusoria is a characteristic symptom.

Findings:

• Diagnosis is confirmed via advanced imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI).
• Barium contrast radiography of the esophagus is indicated for symptomatic evaluation.
• Surgical treatment, specifically transposition of the aberrant vessel, is reserved for symptomatic individuals.

Implications:

• This case highlights the successful surgical management of dysphagia lusoria in a 50-year-old woman via cervical transposition of the aberrant right subclavian artery.
• Effective treatment options exist for symptomatic arteria lusoria, improving patient quality of life.
• Understanding ARSA's prevalence and clinical presentation is crucial for timely diagnosis and management.