Right Aortic Arch with Aberrant Left Subclavian Artery

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

Etiology/Pathophysiology:
This is the most common malformation of the aortic arch resulting in a complete vascular ring around the trachea and esophagus.

Two types exist:

• Origin of the left subclavian artery from a posterior aortic diverticulum from which a ductus arteriosus extends to the left pulmonary artery. The retroesophageal part of the ring is large and compression is produced by the diverticulum.
• Origin of the left subclavian artery from the descending aorta with a left ductus connecting the left subclavian artery to the left pulmonary artery. The retroesophageal part of the ring is small.

The most common type of right aortic arch is right aortic arch with an aberrant left subclavian artery and it is 2-3 times more common than right arch with mirror image branching of the brachiocephalic vessels. Right arch and aberrant left subclavian artery has a 5-12% incidence of associated congenital heart disease while right arch with mirror branching of the brachiocephalic vessels has a 98% incidence of associated congenital heart disease.

Pathology:
Not applicable

Imaging Findings:
The chest film shows a right sided aortic arch. The esophagram shows a posterior indentation on the esophagus.

DDX:

• Not applicable

References:

• Correlapedia

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