Left Aortic Arch with Aberrant Right Subclavian Artery

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

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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