This anomaly is rarely associated with other cardiovascular abnormalities. Respiratory symptoms due to tracheal compression may be present in pediatric patients. Symptoms of esophageal compression may develop in older individuals with ectasia, tortuosity or aneurysm of the ALSA. This anomaly rarely produces symptoms and is usually an incidental radiological finding. In RAA with ALSA, ALSA may arise from a remnant of the left dorsal aortic root (Kommerell’s diverticulum). The Edwards classification describes three types: RAA (right aortic arch) with ALSA (aberrant left subclavian artery), RAA with mirror image branching, and RAA with isolation of the left subclavian artery (LSA). Several classifications of these anomalies have been proposed based on the arrangement of the arch vessels, relationships with the esophagus, or the presence of congenital heart anomalies. It is present in 0.05% to 0.1% of radiology series and in 0.04%-0.1% of autopsy series. Patients diagnosed with type II RAA should be examined with Doppler ultrasonography to identify coincident vascular disorders, especially stenosis of the common carotid arteries or subclavian arteries.Ī right-sided aortic arch is a rare congenital defect of the aorta. Our observations indicate that concomitant vascular abnormalities may occur more often than reported in literature. One patient was found with type B aortic dissection including ALSA and Kommerell’s diverticulum. In two other cases, the aberrant left subclavian arteries (ALSA) were found to be narrowed at the level of origin by up to 70%. In the second coincident right subclavian artery (RSA) stenosis was depicted. In two cases, the right common carotid artery (RCCA) was narrowed by up to 80%, with steal phenomenon confirmed in one of them. Concomitant vascular abnormalities were detected in four patients with type II RAA. Eight of the 11 type II patients presented Kommerell’s diverticulum. The analysis identified nine patients with type I and 11 patients with type II RAA. The type of aortic arch, the occurrence of Kommerell’s diverticulum and possible other vascular abnormalities, such as stenosis, kinking or occlusion, were then investigated. Twenty patients with this diagnosis were identified from a total of 11,690 CT examinations of the chest area, 19,623 CT examinations of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries. The database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 with the keyword “right aortic arch”. The aim of the study was to assess the occurrence of RAA in diagnoses performed by the University Radiology Department and analyze the frequency of concomitant vascular abnormalities. The right-sided aortic arch (RAA) is a rare congenital defect of the aorta.
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