Double aortic arch

Case contributed by Dr Şaban Tiryaki

Presentation

His uncle was recently diagnosed with lung cancer. Then the patient applied to our hospital for control. He had no respiratory complaints

Patient Data

Age: 50 years
Gender: Male
X-ray

Chest

The aortic knob was not observed on the left. There was an expansion in the right upper mediastinum.

CT

Chest

There was a double aortic arch surrounding the trachea and esophagus in the form of a ring. The ascending aortic diameter was 32 mm, the descending aortic diameter was 29 mm, the right aortic arc diameter was 28.4 mm, and the left aortic arc diameter was 13.8 mm. Right aortic arch dominant, left hypoplasia observed. In addition, the right atrium and right ventricle were smaller than the left and their contours were irregular.

Azygos fissure and lobe are incidentally noted.

Case Discussion

Double arcus aorta is a rare congenital anomaly surrounding the trachea and esophagus in the form of a ring. According to Edward, in the embryological life, the right and left aorta combining the truncoaortic sac and the dorsal aorta are formed by the fourth brachial arch not closing and continuing. It is generally isolated and rarely with other cardiac anomalies.

Depending on the degree of compression it makes to the trachea and esophagus, it can be seen most frequently due to shortness of breath or dysphagia. Symptoms depend on whether the vascular ring is loose or tight. If asymptomatic, it is explained that the vascular ring is loose. Symptoms are evident if the vascular ring is tight or there are additional cardiac anomalies.

In our case, the right atrium and right ventricle were smaller than the left and their contours were irregular. Nevertheless, the patient has no complaints and was completely random.

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Case information

rID: 77509
Published: 22nd May 2020
Last edited: 23rd May 2020
System: Vascular, Chest
Inclusion in quiz mode: Included
Institution: NEVŞEHİR STATE HOSPITAL

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