Virtual Pediatric Hospital: Paediapaedia: Left Aortic Arch with Aberrant Right Subclavian Artery

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Virtual Pediatric Hospital: Paediapaedia: Left Aortic Arch with Aberrant Right Subclavian Artery Paediapaedia: Cardiovascular Diseases

Left Aortic Arch with Aberrant Right Subclavian Artery

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Rarely causes respiratory or swallowing problems, and is usually an incidental finding.

Etiology/Pathophysiology:
The normal aorta produces a lateral indentation on the esophagus and slightly displaces the trachea to the right. Variations in great vessel origin include:

70% have the configuration of left aortic arch - right innominate artery, left common carotid artery, left subclavian artery.
25% have the configuration of left aortic arch - right innominate artery and left common carotid artery arising from a common trunk, and left subclavian artery.
5% have all kind of anomalies, with the next most common left arch with aberrant right subclavian artery which is seen in 1 in 200 children.

The aberrant right subclavian artery crosses behind the esophagus and extends obliquely upward to the right arm.

Pathology:
Not applicable

Imaging Findings:
On an esophagram, a characteristic oblique lower left to upper right posterior esophageal indentation is seen.

DDX:

Not applicable

References:
See References Chapter.

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