11 major anomalies of the aortic arch and

11 Major Anomalies of the Aortic Arch and Pulmonary Artery

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig CA 11-1 Right aortic arch with aberrant left subclavian artery. (A) Frontal view from an esophagram demonstrates the right aortic arch (arrow). (B) Oblique posterior impression on the esophagus (arrow) represents the aberrant left subclavian artery as it courses to reach the left upper extremity.

• Fig CA 11-2 Cervical aortic arch. (A) Posterior esophageal impression (arrow) is caused by the retroesophageal course of the distal arch or the proximal descending aorta. (B) Subtraction film from an aortogram demonstrates the aortic arch extending into the neck (arrow).

• Fig CA 11-3 Double aortic arch. Characteristic reverse S-shaped indentation on the esophagus (arrows). As usual, the right (posterior) arch is higher and larger than the left (anterior) arch.6

• Fig CA 11-4 Aberrant right subclavian artery. (A) Lateral view from an esophagram demonstrates a posterior esophageal impression (arrow). (B) On a frontal view, the esophageal impression (arrow) runs obliquely upward and to the right. (C) Subtraction film from an arteriogram shows the aberrant vessel (arrows) arising distal to the left subclavian artery.

• Fig CA 11-5 Aberrant left pulmonary artery. Lateral esophagram demonstrates the characteristic indentation of the anterior wall of the esophagus. Note the posterior impression and anterior displacement of the trachea (arrows) caused by the aberrant artery.11