Unusual vascular ring anomaly associated with a persistent right aortic arch in two dogs

Abstract

An unusual vascular ring anomaly consisting of a persistent right aortic arch and a left ligamentum arteriosum extending from the main pulmonary artery to an aberrant left subclavian artery and left aortic arch remnant complex was identified in a German shepherd dog and a great Dane. The left subclavian artery and left aortic arch remnant complex originated at the junction between the right distal aortic arch and the descending aorta and coursed dorsal to the oesophagus in a cranial direction. The attachment of the ligamentum arteriosum to the aberrant left subclavian artery was approximately 5 cm cranial to the point of origin of the aberrant left subclavian artery and left aortic arch remnant complex from the descending aorta in both dogs. This anomaly observed in both dogs is similar to an anomaly reported in humans, in which a persistent right aortic arch is found in conjunction with an aberrant left subclavian artery and a left aortic arch remnant (Kommerell's diverticulum). Surgical ligation and division of the left ligamentum arteriosum in both dogs, along with division of the left subclavian artery in the great Dane, resulted in resolution of clinical signs in both of the dogs in this report.

Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: Patent ductus arteriosus and vascular rings

“…In addition, 4 dogs showed a mild dilation of the aberrant left subclavian artery at its aortic origin. Analogous conditions were described in a case report of 2 dogs in veterinary medicine [25]. However, to the authors' knowledge, there have been no previous reports of Kommerell's diverticulum in cats.…”

“…Several of these anomalies, such as patent right ductus arteriosus, aberrant right subclavian artery, and some forms of double aortic arches, may necessitate a right intercostal approach [3]. Therefore, some authors recommend an additional angiographic examination before surgery [24,25]. In contrast, other authors have doubts about the use of angiography in these cases because the examination of aortic arch vessels has been proven difficult, even with biplane angiography, because of the 3-dimensional nature of vascular anomalies [23].…”

Adult‐onset regurgitation in a dog with an aberrant right subclavian artery: a CT angiographic study

“…In cats and dogs, the most common VRA reported is a persistent right aortic arch with a left ligamentum arteriosum, accounting for 95 per cent of cases (Vangundy 1989, Buchanan 2004). Other VRAs reported in the veterinary literature include double aortic arch (Helphrey 1979, Suter and Lord 1984, Vangundy 1989, Buchanan 2004, Vianna and Krahwinkel 2004, Du Plessis and others 2006), right patent ductus arteriosus or right-sided ligamentum arteriosum (Helphrey 1979, VanGundy 1989, Hurley and others 1993, Holt and others 2000, Buchanan 2004), persistent right dorsal aorta (VanGundy 1989), abberant intercostal arteries (Bellenger 1970, VanGundy 1989) and aberrant left and right subclavian vessels (Detweiler and Allam 1955, Buergelt and Wheaten 1970, DeKleer 1971, Tsukise and others 1972, Helphrey 1979, Suter and Lord 1984, Bezuidenhout 1989, Griffiths 1989, VanGundy 1989, Buchanan 2004, House and others 2005, Park and others 2005, Yoon and Jeong 2011). …”

Hypoplastic aberrant left subclavian artery in a dog with a persistent right aortic arch

“…6 Additionally, connection of a ligamentum arteriosum from the main pulmonary artery to an aberrant LSA rather than the aortic arch causing esophageal compression has also been reported in dogs with PRAA. 13,14 A previous case report also describes an 'obliterated' aberrant LSA in two dogs with PRAA suggesting complete loss of anatomical detail and vessel patency, however a detailed description and/or images were not provided. 7 In human medicine, reports exist of congenital LSA atresia and stenosis associated with PRAA.…”