Right sided aortic arch with aberrant left subclavian artery

Clinical:

  • A 32 years old man
  • Recently diagnosed retroviral positive with oncomycosis
  • CT scan of thorax, abdomen and pelvis for assessment of his condition
CT scan thorax in soft tissue window post contrast axial plane
Reformatted CT scan image in coronal plane

CT scan findings:

  • Multisegmental collapsed of lungs due to proximal narrowing of its bronchi from external compression with multiple mediastinal and axillary lymphadenopathies.
  • There is right-sided aortic arch (red arrows).
  • The left subclavian artery (yellow arrows) is seen coursing posterior to the esophagus before entering the aortic arch.

Radiological diagnosis: Incidental finding of right sided aortic arch with aberrant left subclavian artery.

Discussion:

  • A right-sided aortic arch is thought to occur in approximately ~0.1% of the population.
  • Right-sided aortic arch is a type of aortic arch variant characterized by the aortic arch coursing to the right of the trachea.
  • Different configurations can be found based on the supra-aortic branching patterns
    • Type I: right-sided aortic arch with mirror image branchin
    • Type II:  right-sided aortic arch with aberrant left subclavian artery (ALSA).
    • Type III: right-sided aortic arch with isolation of the left subclavian artery
  • The right sided aortic arch with aberrant left subclavian artery is common, accounting for 39.5% of all right-sided arches. It rarely produces symptoms and is usually an  incidental finding. Rarely it may cause esophageal and/or tracheal compression. It is rarely associated with other cardiovascular abnormalities
Author: radhianahassan