A case of double aortic arch accompanied by sub-aortic and pre-aortic left brachiocephalic veins and anomalous origin and course of left vertebral artery

Abstract

During the elective course of human dissection at the University of Toyama in 2007, we encountered a rare case of double aortic arch accompanied by sub- and pre-aortic left brachiocephalic veins (LBV), and anomalous origin and course of the left vertebral artery in a Japanese elderly female. The double aortic arch formed a complete vascular ring that encircled the trachea and the esophagus. The sub-aortic LBV traversed below the aortic arches between the ascending aorta and the trachea. In addition, there was a small pre-aortic LBV passing anterior to the origins of the aortic arches. The left vertebral artery originated from the left aortic arch and entered the transverse foramen of C3, while the right vertebral artery originated from the right subclavian artery and entered the transverse foramen of C6.

Double left brachiocephalic veins with vascular ring and normal intracardiac anatomy: Prenatal diagnosis of a rare association

“…In most reported cases, double LBCVs were discovered accidentally on investigating associated cardiovascular anomalies or rhythm disorders 2‐5 . In the current work, we report for the first time associated double LBCVs with a vascular ring in a fetus with further assessment after birth.…”

“…The coexistence of double LBVs with the right aortic arch‐aberrant left subclavian type of vascular ring has never been reported. A report on cadaveric dissection described a double aortic arch with double LBVs 5 …”

Anatomical study of the coexistence of the postaortic left brachiocephalic vein with the postaortic left renal vein with a review of the literature

“…There have been some morphological reports on the PALBV in dissecting cadavers (Kerschner, 1888;Daser, 1902;Ghon, 1908;Nützel, 1914;Martin, 1931;Walter, 1931;Adachi, 1933;Freidman, 1945;Jakubczik and Zeigler, 1963;Yoshida and Fukuyama, 1975;Kitamura, 1981;Yoshida, 1984;Tsujimura, 2007;Ohsawa, 2009; R. Ohsawa, 2011). The reports on the anomaly except those based on dissection, were based on the observations during the clinical diagnosis and operation.…”

“…The azygos vein joins the superior vena cava just before it enters the right atrium in the upper right anterior part of the heart. There have been reports discussing a variation, which shows that the left brachiocephalic vein passes behind the ascending aorta and connects with the right brachiocephalic vein (Kerschner, 1888;Daser, 1902;Ghon, 1908;Nützel, 1914;Martin, 1931;Walter, 1931;Adachi, 1933;Freidman, 1945;Jakubczik and Zeigler, 1963;Yoshida and Fukuyama, 1975;Kitamura, 1981;Yoshida, 1984;Tsujimura, 2007;Ohsawa, 2011).…”

A tale of two rings

“…Its association with an arterial ring is extremely rare, and to date, there has been only one case of double vascular ring described in an autopsy specimen. 1 We describe a rare case of double vascular ring consisting of duplication of the innominate vein, constituting a circumaortic venous ring and a right aortic arch with aberrant left subclavian artery and diverticulum of Kommerell, constituting an arterial vascular ring, if the left arterial duct was left alone. This could have potentially caused compression of the airway or oesophagus, requiring surgical division of the ring.…”