Coexistence of bicuspid aortic valve, aberrant right subclavian artery and common origin of carotid arteries

Abstract

Although coexistence of ASA and BAV has not been reported in paediatric population, it has been diagnosed in very few adults as well as in our series. Additional presence of COCA in this group seems to be very rare. From practical point of view, heart cannulation via the radial artery and subsequent ASA may be challenging. Similarly, COCA presence may have surgical implications during corrective procedures.

Abnormal Origin of Right Subclavian Artery-Embryological Basis and Clinical Significance

“…1 ARSApatients are at higher risk of iatrogenic injuries, while performing imaging studies and catheter-based techniques for aortic arch and great vessels. 19 Invasive procedures on the oesophagus such as thoracoscopic oesophagectomy can accidentally injure an ARSA. 1 Transient compression of ARSA during transesophageal echocardiography imaging can impair haemodynamic monitoring if radial arterial catheters are used on the affected side.…”

“…1 ARSA can be diagnosed by plain chest x-ray, barium oesophagogram (oblique compression of the oesophagus at the level of third and fourth thoracic vertebrae), computed tomography images, magnetic resonance images and angiographies. 19 CT or MRI is considered the gold standard for the diagnosis, since it helps to plan the operation and excludes other associated anomalies. It is difficult to preoperatively diagnose NRLN by any current imaging technique.…”