Right aortic arch with aberrant left subclavian artery: symptomatic in adulthood

A 42 year old black woman presented initially with symptoms of acute aortic dissection. She subsequently had symptoms of esophageal obstruction that were proved aortographically to be due to right aortic arch with an aberrant left subclavian artery. Relief of the esophageal obstruction was achieved only after dividing the aortic arch posteriorly and freeing the trachea and esophagus from the surrounding structures.