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(Circulation. 2004;109:2370-2371.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Double Aortic Arch

Apoor S. Gami, MD; Naser M. Ammash, MD

From the Division of Cardiovascular Diseases and Internal Medicine, The Mayo Clinic College of Medicine, Rochester, Minn.

Correspondence to Apoor S. Gami, MD, 200 First St SW, Rochester, MN 55905. E-mail gami.apoor@mayo.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 54-year-old woman presented with a 1-year history of a full sensation in the throat and an 8-month history of dysphagia with meat and large pills. She was treated for gastroesophageal reflux disease without relief. An esophagram revealed mild compression of the cervical esophagus. Chest MRI revealed a congenital double aortic arch with a larger and more cephalad right arch (Figures 1 and 2 , R) than left arch (Figures 1 and 2, L). Separate subclavian and common carotid arteries arose from each arch. Within the vascular ring the trachea was normal; however, the esophagus was obstructed. The patient underwent a left posterolateral thoracotomy with division of the left aortic arch just distal to the origin of the left subclavian artery and division of the ligamentum arteriosum, thus freeing the esophagus. She had marked improvement in her symptoms.

View larger version (71K): [in this window] [in a new window]   Figure 1. Double aortic arch: anterior perspective. Three-dimensionally reconstructed magnetic resonance angiogram of the aorta and great vessels. L indicates left aortic arch; R, right aortic arch.

View larger version (60K): [in this window] [in a new window]   Figure 2. Double aortic arch: left posterior perspective. Three-dimensionally reconstructed magnetic resonance angiogram of the aorta and great vessels. L indicates left aortic arch; R, right aortic arch.

The authors received funding for this article from the Mayo Clinic.

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

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