Aneurysms of an aberrant right subclavian artery: Report of two cases

Aberrant right subclavian artery: a novel approach and an overview of operative techniques

“…If the anatomy is particularly challenging, the use of hypothermic circulatory arrest can be implemented. 9 The resulting operation could require aortic arch reconstruction, which has been shown to be associated with a statistically significant increase in the length of hospital stay, prolonged mechanical ventilation, and pneumonia. 10 …”

Cardiovascular dysphagia — anatomical and clinical implications

“…ARSA is the most common congenital vascular anomaly of the aortic arch, accounting for 0.5-1.8% of the cases in general population [42,67]. Dysphagia secondary to extrinsic oesophageal compression by an ARSA is called dysphagia lusoria (Fig.…”

“…ARSA is located retro-oesophageally in 80-83%, between the oesophagus and the trachea in 12-15% and anterior to both in 4-5% of the patients, respectively [32,96]. Most of the patients are asymptomatic and do not require surgical intervention, however, in a few patients, symptoms usually occur when ARSA becomes ectatic and tortuous, especially in the patients with concurrent aortic aneurysm or atherosclerosis [42]. 17% of the patients had dysphagia alone [96].…”

“…There was 1 (10%) perioperative death in a patient undergoing aortic arch debranching with placement of an aortic endograft [96]. Aberrant subclavian artery resection and reanastomosis to the ascending aorta performed via left-, or right--thoracotomy or median sternotomy under profound hypothermic circulatory arrest is a traditional surgical technique [42], and more recently, right supraclavicular cervicotomy approach is proposed [76]. Mobilisation of the retro-oesophageal course or complete proximal resection of the lusorian artery is recommended to reduce oesophageal compression.…”