The Surgical Management of Aortic Root Vessel Anomalies Presenting in Adults

Anatomy and radiology of the variations of aortic arch branches in 1,266 patients

“…There are often various combinations of 2 or more aberrant arteries in the same patient A B [3,6,10,11]. Similarly, a combination of aberrations of both branches and the aortic arch variations can be observed, especially in patients with a double or a right-sided aortic arch [1,9,18,35]. By comparing the frequencies in our study, it is clear that type III, i.e.…”

“…Thus, a double or a right-sided aortic arch, then a common stem of the RCCA and LCCA, a left BCT, a double BCT, or a retroesophageal RSCA, may cause a compression of the trachea and the oesophagus and hence dyspnoea, cough, recurrent respiratory infections, and dysphagia [1,3,9,11,27,34]. In the latter case, an arterioesophageal fistula may develop, which is usually a fatal event [11].…”

“…in the thorax, or very high -at the level of the hyoid bone or even the styloid process, which is important in thoracic, neck, and head surgery [1,34]. Non-recognition of certain aberrant aortic arch branches at surgery may have fatal consequences [27].…”

“…Statistical methods comprised counting of the percentages related to the whole series of patients (1,266), as well as to a group with the arterial variations (320).…”

“…They are, however, more important for thoracic operations, especially in vascular, cardiac, oesophageal, and mediastinal surgery [1,9,12,14,34]. Modern radiological techniques, especially computerised tomographic angiography (CTA), magnetic resonance angiography (MRA), multislice CT (MSCT), and MSCT angiography, have enabled an elegant insight into the thoracic blood vessels [21,27].…”