Mirror-image right aortic arch: A proposed mechanism in symptomatic vascular ring

D'Souza, Vincent J.; Velasquez, Guillermo; Glass, Ted A.; Formanek, A

doi:10.1007/bf02552878

Cited by 17 publications

(7 citation statements)

References 8 publications

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“…If the left distal aortic arch, distal to origin of the left subclavian artery, disappears, a mirror image banching is developed as a result [3]. Complete vascular rings, caused by the right aortic arch with mirror image branching, are extremely rare [4]. …”

Section: Discussionmentioning

confidence: 99%

Complete Vascular Ring Caused by Kommerell's Diverticulum and Right Aortic Arch with Mirror Image Branching

Ryu

2012

Korean J Thorac Cardiovasc Surg

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Vascular ring, caused by Kommerell's diverticulum and ligamentum arteriosum, in a patient with right aortic arch and mirror image branching is extremely rare. A 10-month-old boy with coughing and stridor was diagnosed as having tracheo-esophageal stenosis, which is caused by a vascular ring with Kommerell's diverticulum, ligamentum arteriosum, right aortic arch, and mirror image branching. Kommerell's diverticulum was successfully resected via a left thoracotomy. The patient has been free from tracheo-esophageal stenosis for a year after the surgery.

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Section: Discussionmentioning

confidence: 99%

Complete Vascular Ring Caused by Kommerell's Diverticulum and Right Aortic Arch with Mirror Image Branching

Ryu

2012

Korean J Thorac Cardiovasc Surg

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“…Less commonly, the left sixth arch will regress with persistence of the right, resulting in a true mirror image of the normal arch. Very rarely, and typically not with CHD, a vascular ring may be created if the left ligamentum arteriosum extends from the left pulmonary artery to a leftsided retroesophageal aortic diverticulum from the right-sided upper descending aorta (38). Unlike a right arch with aberrant left subclavian artery arising from a diverticulum of Kommerell, no arch vessel arises from the diverticulum (or dimple) in this case.…”

Section: Right Aortic Arch With Mirror Image Branchingmentioning

confidence: 92%

Congenital Variants and Anomalies of the Aortic Arch

Hanneman¹,

Newman²,

Chan³

2017

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269

274

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Congenital variants and anomalies of the aortic arch are important to recognize as they may be associated with vascular rings, congenital heart disease, and chromosomal abnormalities, and can have important implications for prognosis and management. The purpose of this article is to review cross-sectional imaging techniques used in the evaluation of the aortic arch, describe the embryology and anatomy of the aortic arch system, discuss aortic arch variants and anomalies, and review other malformations of the aortic arch, including interrupted aortic arch, hypoplastic aortic arch, and aortic coarctation. Aortic arch variants and anomalies will be reviewed in the context of a theoretical double aortic arch system. Arch anomalies can be associated with symptoms, such as dysphagia lusoria in the setting of left aortic arch with aberrant right subclavian artery. Arch variants that form a vascular ring, such as double aortic arch, can result in respiratory distress due to tracheal compression. Certain arch anomalies are strongly associated with congenital heart disease, including right aortic arch with mirror image branching. Other malformations of the aortic arch have important associations, such as type B interrupted aortic arch, which is associated with a locus 22q11.2 microdeletion. Noninvasive imaging at CT angiography and MR angiography allows for comprehensive evaluation of the aortic arch and branch vessels in relation to surrounding structures. Familiarity with the spectrum and imaging appearances of aortic arch variants, anomalies, and malformations is essential for accurate diagnosis and classification and to guide management. Online supplemental material is available for this article. RSNA, 2016.

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“…However, when the ligamentum arteriosum or the ductus arteriosus is attached to the aortic diverticulum posteriorly and to the pulmonary artery anteriorly, a vascular ring is formed. In this condition, severe symptoms have been shown to be often present [6]. In the present case, the patient was asymptomatic maybe because the ligamentum arteriosum was highly degenerated.…”

Section: Discussionmentioning

confidence: 75%

“…In the previous literatures, a right aortic arch with mirror image branching has been reported to be rarely associated with a vascular ring [6]. This may be because the ligamentum arteriosum or the ductus arteriosus is often attached to the left brachiocephalic artery anteriorly.…”

Section: Discussionmentioning

confidence: 90%