Double Aortic Arch With a Compressed Trachea Demonstrated by Multislice Computed Tomography
A 33-year-old man had a chest x-ray that showed an abnormal enlargement of the thoracic aorta. ECG-gated enhanced multislice computed tomography (CT) (Light Speed Ultra 16, General Electric) was therefore performed with a 0.625-mm slice thickness and a helical pitch of 3.25. Thirty seconds after intravenous injection of 100 mL of iodinated contrast material (350 mgI/mL), CT scanning was performed with retrospective ECG-gated reconstruction and volume data were transferred to a workstation (Virtual Place Office, Azemoto, Tokyo, Japan).
Axial source images (Figure 1A) and multiplanar reconstruction images of the coronal view (Figure 1B) revealed separated right and left aortic arches and a trachea and esophagus surrounded by a vascular ring made by the double aortic arches. The trachea was actually slightly compressed by the vascular ring (Figure 1B, arrowhead). Three-dimensional volume rendering images also revealed the double aortic arch, which was separated at the distal portion of the ascending aorta (Figure 2A) and joined at the proximal portion of the descending aorta (Figure 2B). The right subclavian artery and right common carotid artery both originated separately from the right aortic arch, and the left subclavian artery and left common carotid artery originated from the left aortic arch. Because the patient did not experience symptoms of compression of the esophagus or trachea, surgical intervention is not currently planned.
This work was supported by Japan Cardiovascular Research Foundation.