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Demonstration of a right circumflex aortic arch with aberrant left subclavian artery and a hypoplastic arch by multi-detector computer tomography

Published online by Cambridge University Press:  28 January 2011

Wesley Mann*
Affiliation:
Department of Radiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
Roger Shifrin
Affiliation:
Department of Radiology, College of Medicine, University of Florida, Gainesville, Florida, United States of America
Arun Chandran
Affiliation:
Department of Pediatrics, Congenital Heart Center, University of Florida, Gainesville, Florida, United States of America
*
Correspondence to: Dr W. Mann, Department of Radiology, University of Florida, PO Box 100286, Gainesville, Florida 32610-0296, United States of America. Tel: (352) 246 2394; Fax: (352) 265 0279; E-mail: wmannmd@gmail.com
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Abstract

Type
Images in Congenital Cardiac Disease
Copyright
Copyright © Cambridge University Press 2011

A right-sided circumflex aortic arch (as defined by its bow-like curvature) is an extremely rare defect with only a few cases reported in the literatureReference Song, Kim and Kim1 to date. We report a case of a newborn who presented with respiratory distress and poor lower extremity pulses described by a preliminary echocardiogram to have a right-sided aortic arch with a hypoplastic transverse segment and a ventricular septal defect. A subsequent computed tomogram demonstrated a right ascending aorta (Fig 1) connected to a very hypoplastic transverse aorta (Arch), which was retro-oesophageal in location (Figs 2 and 3). An aberrant left subclavian artery arose from the distal end of the transverse arch (Fig 3: small arrow) and finally descended on the left side of the vertebral column (Fig 3: asterisk). A three-dimensional volume-rendered reconstruction (Fig 4) was also of great benefit to our cardiothoracic surgery team which formulated a novel surgical approach to this particular defect using an extended end-to-side repair with arch augmentation without the need of a conduit.

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Figure 4

References

1. Song, J, Kim, WH, Kim, H, et al. . Repair of coarctation in right circumflex retroesophageal arch. Ann Thorac Surg 2009; 87: 307309.CrossRefGoogle ScholarPubMed
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