Anat Cell Biol.  2013 Jun;46(2):167-170. 10.5115/acb.2013.46.2.167.

Right-sided aortic arch with the retroesophageal left subclavian artery as the fourth branch

• Chai OH
• Han EH
• Kim HT
• Song CH

• KMID: 2263112
• DOI: http://doi.org/10.5115/acb.2013.46.2.167

Abstract

We present a rare variation of the right-sided aortic arch with the retroesophageal left subclavian artery as the forth branch found in a cadaver of an 89-year-old Korean woman during a routine dissection. In this case, the first branch that arose from the ascending aorta was the left common carotid artery, which crossed ventral to the trachea in a left cephalic direction, followed by the right common carotid artery and then the right subclavian artery. Distal to these branches the aortic arch ran dorsally, passing between the esophagus and the vertebra. The left subclavian artery arose from the descending portion of the aortic arch, crossing over to the left upper extremity behind the esophagus. This anomaly was not accompanied by congenital heart disease. Accurate information regarding this variation is of great importance to surgeons for its early identification and preservation during interventions and to radiologists for precise interpretation of angiograms.

Keyword

Right-sided aortic arch; Retroesophageal left subclavian artery

MeSH Terms

Aorta
Aorta, Thoracic
Cadaver
Carotid Artery, Common
Crossing Over, Genetic
Esophagus
Female
Heart Diseases
Humans
Spine
Subclavian Artery
Trachea
Upper Extremity

Figure

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  Fig. 1 A ventral view of the right-sided aortic arch before (A) and after (B) the heart and lungs were removed. AA, aortic arch; DA, descending aorta; LCC, left common carotid artery; LS, left subclavian artery; RCC, right common carotid artery; RS, right subclavian artery; Th, thyroid gland.

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  Fig. 2 Photographs of the right-sided aortic arch variation. Ventral (A), medial (B), and dorsal (C) views. AA, aortic arch; AD, aortic diverticulum; DA, descending aorta; LA, ligamentum arteriosum; LCC, left common carotid artery; LS, left subclavian artery; LV, left vertebral artery; RCC, right common carotid artery; RS, right subclavian artery; RV, right vertebral artery.

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