Right aortic arch with retroesophageal left ligamentum arteriosum.
A 49-year-old woman with a 2-year history of severe dysphagia, claudication of the right arm, and persistent pulsatile back pain presented at our institution. An esophagogram showed 2 marked indentations of the upper esophagus. Computed axial tomography showed a right-sided aortic arch with mirror image branching and an aortic diverticulum; the thoracic aorta distal to the origin of the right subclavian artery was elongated and tortuous, ascending to the base of the neck to form the "2nd arch", which compressed the right-arm plexus nerve and the upper vertebral column. Through a right thoracotomy, a segment of thoracic aorta around the Kommerell's diverticulum was resected, and the proximal and distal ends of the thoracic aorta were reapproximated. The patient tolerated the procedure well and remained symptom free.
Zhao
Jinping
J
Department of Cardiothoracic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, 430030 Wuhan, People's Republic of China. jpzhao@tjh.tjmu.edu.cn
Liao
Yongde
Y
Gao
Sihai
S
D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001416:Back Pain / Q000209:etiology; D006348:Cardiac Surgical Procedures; D019299:Decompression, Surgical; D003680:Deglutition Disorders / Q000209:etiology; D004936:Diverticulum, Esophageal / Q000000981:diagnostic imaging / Q000209:etiology; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed