Arteria lusoria aneurysm with truncus bicaroticus: surgical resection without restoring blood supply to the right arm.
Arteria lusoria, an aberrant or anomalous right subclavian artery, is the most common anomaly of the aortic arch. It may be associated with other congenital anomalies of the heart and great vessels-including, rarely, truncus bicaroticus (a common trunk of both common carotid arteries), and, even more rarely, aneurysmal formation.Herein, we report the case of a 72-year-old man who had both an atherosclerotic aneurysm of an aberrant right subclavian artery and truncus bicaroticus. We resected the aneurysm through a posterolateral thoracotomy and did not restore the distal pulsatile blood supply to the right arm. During long-term clinical follow-up, the patient experienced no arm ischemia or cerebrovascular insufficiency.Aneurysm of arteria lusoria should be suspected in the presence of a right superior mediastinal mass on chest radiographs and should be considered as a cause of new-onset dyspnea, chest pain, or dysphagia. Symptomatic right arteria lusoria aneurysm should be removed promptly after diagnosis. Despite disagreement among investigators regarding the need to restore pulsatile blood flow to the right arm, we recommend reconstructing that flow, when possible.
Department of Anesthesiology, Klinikum Bayreuth GmbH, D-95445 Bayreuth, Germany. dr.gsaeed@web.de
Giovanni
G
Saeed
George
G
Ganster
Norbert
N
Friedel
D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D017536:Carotid Artery, Common / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008026:Ligation; D008297:Male; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D013348:Subclavian Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D054079:Vascular Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014656:Vascular Surgical Procedures