[A case report of the incomplete double aortic arch]

Area of Science:

• Cardiovascular Anatomy
• Congenital Vascular Malformations

Background:

• Double aortic arch is a rare congenital anomaly where the aortic arch forms a complete ring around the trachea and esophagus.
• Incomplete forms of this anomaly can present with varied anatomical configurations and clinical significance.

Observation:

• A case of incomplete double aortic arch was identified in a 69-year-old male during a medical school dissection.
• The anomaly featured a right aortic arch with a cord-like remnant of the left aortic arch.
• This cord-like structure formed a vascular ring compressing the trachea and esophagus, with an associated aortic diverticulum.

Findings:

• Histological examination of the cord-like left aortic arch revealed a closed structure lacking a tunica intima, with scattered elastic and collagen fibers and penetrating blood vessels.
• The ligamentum arteriosum connected to the aortic diverticulum, and aberrant looping of the recurrent laryngeal nerves and thoracic duct were noted.
• The left brachiocephalic trunk was considered the initial portion of the rudimentary left aortic arch.

Implications:

• This case highlights the diverse anatomical presentations of incomplete double aortic arch and its potential for forming a vascular ring.
• Understanding such anomalies is crucial for accurate diagnosis and surgical management of related vascular and airway complications.
• The findings contribute to the detailed anatomical description of aortic arch variations and their embryological basis.