J Cardiovasc Ultrasound.  2011 Sep;19(3):163-166. 10.4250/jcu.2011.19.3.163.

A Case of Balanced Type Double Aortic Arch Diagnosed Incidentally by Transthoracic Echocardiography in an Asymptomatic Adult Patient

• Seo HS
• Park YH
• Lee JH
• Hur SC
• Ko YJ
• Park SY
• Kim JH
• Kim YJ
• Kim SY
• Kwon NH

• KMID: 1980374
• DOI: http://doi.org/10.4250/jcu.2011.19.3.163

Abstract

A 36-year-old male patient with no remarkable medical history was admitted to our hospital for a health check up. On chest radiography, bilateral aortic notches at the level of aortic arch were shown suggesting aortic arch anomaly without any clinical symptoms. Two aortic arches were almost same-in-size on suprasternal view of transthoracic echocardiography. In addition, multidetector computed tomography showed balanced type double aortic arch forming a complete vascular ring which encircled the trachea and esophagus. The trachea was slightly compressed by the vascular ring whereas the esophagus was intact. Nevertheless, the pulmonary function test was normal. The patient was discharged from hospital with instructions for periodic follow-up.

Keyword

Double aortic arch; Echocardiography; Vascular ring

MeSH Terms

Adult
Aorta, Thoracic
Echocardiography
Esophagus
Follow-Up Studies
Humans
Male
Multidetector Computed Tomography
Respiratory Function Tests
Thorax
Trachea

Figure

• 

  Fig. 1 Chest radiography showed bilateral aortic notches at the level of aortic arch, suggesting aortic arch anomaly. Right aortic arch (large arrow) and left aortic arch (small arrow) can be seen.

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  Fig. 2 Transthoracic echocardiography showed double aortic arch. Descending aorta which is located in the middle can be seen posterior to left atrium on parasternal short axis view (arrow) (A). Right aortic arch (left arrow) and left aortic arch (right arrow) (B) can be found together and respectively, right aortic arch (C), left aortic arch (D) and their branches on suprasternal view. RAA: right aortic arch, RCCA: right common carotid artery, RSCA: right subclavian artery, LAA: left aortic arch, LCCA: left common carotid artery, LSCA: left subclavian artery.

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  Fig. 3 Chest computed tomography showed double aortic arch. Right aortic arch (A) and left aortic arch (B) can be seen and both aortic arches fuse into descending aorta located in front of the spine (C).

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  Fig. 4 Reconstructed images of chest computed tomography showed balanced type double aortic arch (A) with only slight compression of the trachea (B).

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