Magnetic resonance imaging of a left circumflex aortic arch and aberrant right subclavian artery: the other vascular ring

McLeary, Michael S.; Frye, Lynda L.; Young, Lionel W.

doi:10.1007/s002470050347

Cited by 16 publications

(11 citation statements)

References 5 publications

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“…It gives a detailed description of the anatomy of the anomalous vessels and their relationship with the trachea and the esophagus, as well as other structures such as constricting ligaments forming the vascular ring [1,8,10]. In this series, the diagnostic yield of MRI was very high (97.43%, 38/39 cases).…”

Section: Discussionmentioning

confidence: 89%

“…Vascular rings encompass a wide and heterogeneous group of anomalies of the aortic arch and its vessels, causing compression to the trachea or esophagus by forming a complete or partial ring [7][8][9][10][11]. In the current series, patients with complete ring formation constituted 3 patients with a double aortic arch and 13 patients with a right aortic arch and ALSA stemming from the retroesophageal diverticulum of Kommerell and the left ductal ligament.…”

Section: Discussionmentioning

confidence: 99%

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Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

et al. 2012

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This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and the surgical treatment of vascular rings. Data for 44 patients (32 enrolled prospectively, 12 reviewed retrospectively) over a 10-year period in a tertiary referral center were analyzed. These patients comprised 25 patients with a left aortic arch and an aberrant right subclavian artery, 13 patients with a right aortic arch and a left subclavian artery originating from Kommerell’s diverticulum, 1 patient with a right aortic arch and an aberrant left subclavian artery, 3 patients with a double aortic arch, and 2 patients with a pulmonary sling. Respiratory symptoms were found in 25 patients and dysphagia in 6 patients. Atypical symptoms such as reflex apnea, cyanosis, syncope episodes, and exercise-induced wheezing were noted in five patients. Associated congenital heart defects were detected in 41% of the patients. The diagnostic yield was 95.23% for barium esophagography, 54.54% for echocardiography, and 66.66% for computed tomography. The anatomy could be correctly identified by magnetic resonance imaging (MRI) in 97.43% and by angiography in 90.5% of the patients. Of the 30 patients who underwent surgery, 80% were completely relieved of symptoms during a mean follow-up period of 25 ± 33.5 months. Vascular rings should not be overlooked in infants with atypical symptoms. The authors’ diagnostic procedure of choice is MRI because it is superior to angiography for delineating the relationship between abnormal vascular structures, trachea, and esophagus.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

et al. 2012

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“…In this anomaly the aortic arch itself courses behind esophagus. The vascular ring is completed by a segment of aortic arch on the left side along with a retroesophageal segment of aortic arch, ductus arteriosus on the right, and pulmonary artery on the anterior aspect (40). The embryological basis of this pathology is regression of the right fourth branchial arch between right common carotid and right subclavian artery along with persistence of the right ductus arteriosus and right dorsal aorta.…”

Section: Left Circumflex Aortamentioning

confidence: 99%

Congenital anomalies of the aortic arch

Priya

Thomas

Nagpal

et al. 2018

Cardiovasc. Diagn. Ther.

101

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Congenital anomalies of the aortic arch include diverse subgroups of malformations that may be clinically silent or may present with severe respiratory or esophageal symptoms especially when associated with complete vascular rings. These anomalies may be isolated or may be associated with other congenital heart diseases. Volume rendered computed tomography (CT) and magnetic resonance angiography (MRA) help in preoperative surgical planning by providing information about the complex relationship of aortic arch and its branches to the trachea and esophagus. Three dimensional capabilities of both computed tomography angiography (CTA) and MRA are helpful in determining evidence of tracheal or esophageal compression or other high-risk features in patients with a complete vascular ring.

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“…A circumflex retroesophageal aortic arch is the third most common type of vascular ring and occurs when a portion of the aortic arch (either right or left) extends behind the oesophagus while the ascending and descending thoracic aortic segments are located on either side of the spine [33]. In patients with a right arch, the arch runs to the right of the trachea, after which it abruptly courses behind the oesophagus (above the level of the carina) to reach the left where it continues as the descending thoracic aorta (Fig.…”

Section: Circumflex Retroesophageal Right Aortic Archmentioning

confidence: 99%

Computed tomography in the evaluation of vascular rings and slings

et al. 2014

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Vascular rings are congenital abnormalities of the aortic arch-derived vascular and ligamentous structures, which encircle the trachea and oesophagus to varying degrees, resulting in respiratory or feeding difficulties in children. A sling is an abnormality of the pulmonary arterial system resulting in airway compression. Although several imaging examinations are available for the evaluation of these anomalies, computed tomography (CT) has become the preferred test because of rapid acquisitions, making it feasible to perform the study without sedation or general anaesthesia. Furthermore, CT provides excellent spatial and temporal resolution, a wide field of view, multiplanar reconstruction capabilities and simultaneous evaluation of the airway. In this review, the current role and technique of CT in the evaluation of vascular rings are discussed. A brief discussion of the embryology of the aorta and branch vessels is followed by discussion and illustration of common and some uncommon vascular rings along with critical information required by surgeons.Teaching Points• Computed tomography is valuable in the evaluation of vascular rings.• Due to variable clinical and imaging presentations, diagnosis of vascular rings is often challenging.• Laterality of the arch is critical in surgical management.

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Magnetic resonance imaging of a left circumflex aortic arch and aberrant right subclavian artery: the other vascular ring

Cited by 16 publications

References 5 publications

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

Vascular Rings: Presentation, Imaging Strategies, Treatment, and Outcome

Congenital anomalies of the aortic arch

Computed tomography in the evaluation of vascular rings and slings

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