Diagnostic evaluation and surgical management of the aberrant right subclavian artery

A case of dysphagia and dyspnea secondary to compression of the esophagus and the trachea by an aberrant right subclavian artery is presented. As the pathology of the aberrant right subclavian artery is extremely diverse, the diagnosis without radiologic investigation is hardly feasible. Conventional angiography of the aortic arch may be avoided by 3-dimensional magnetic resonance angiography, that is a suitable noninvasive method to diagnose and visualize the vascular pathology and the postoperative results after corrective vascular surgery. With the use of a Gore-Tex prosthesis the right aberrant subclavian artery was successfully translocated to the ascending aorta through a mid-sternal, transmediastinal approach. In contrast to previous reports the retro-esophageal vascular segment was kept in situ. The literature is reviewed with the reference to the diagnostic procedure and the treatment of dysphagia lusoria.