Vascular Rings and Slings

Right aortic arch with brachio‐bicephalic trunk mimicking an incomplete double aortic arch with distal left arch atresia

“…it is expected of the left brachiocephalic artery to have a relatively anterior position (which is not seen in the present case and resulted in the initial misinterpretation) compared to a more posterior location of the proximal left arch in incomplete double‐aortic‐arch (Figure 1A). 4 However, in view of the findings of Schlesinger et al the absence of symmetric origin of arch vessels from either arches and absence of aortic diverticulum posteriorly helped us rule out the diagnosis of an incomplete double‐aortic‐arch with distal left arch atresia 2 …”

“…An incomplete double‐aortic‐arch with distal left arch atresia shows symmetric origin of bilateral common carotid and subclavian arteries from respective arches along with an outpouching from the descending thoracic aorta where the fibrous remnant of the left atretic arch inserts 2–4 . These two features can be used to reliably differentiate it from a right‐sided aortic arch with brachio‐bicephalic trunk 2 .…”