Double Aortic Arch
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.
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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