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The Aorta and Related Disorders (except trauma).
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Despite the idea that an aberrant subclavian artery is a common cause of symptoms, nearly all patients are asymptomatic, but a Kommerell aneurysm may cause dysphagia, dyspnoea, or a Homer's syndrome. Such aneurysms may also be a source of emboli passing peripherally into the right arm. They can also erode into the oesophagus or the trachea leading to a gross fatal haematemesis or haemoptysis.
Safe Thyroidectomy
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Madan Laxman Kapre, Sankar Viswanath, Rajendra Deshmukh, Neeti Kapre Gupta
Any history of aspiration or reflex cough on drinking liquids may suggest invasion of the external branch of the superior laryngeal nerve (EBSLN), and one needs to warn the patient of the possibility of worsening of this symptom. Pre-operative ultrasonography (USG) or computed tomography (CT) of the chest may indicate an aberrant subclavian artery and thus a non-recurrent RLN [17]. Prominent neck veins with retrograde venous flow is an indication of venous obstruction in the superior mediastinum [18]. Retrosternal goiter if benign has its blood supply from the neck but retrosternal malignant thyroid may have additional vessels from the adjoining superior mediastinum.
Cardiology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
The most common vascular ring is caused by a double aortic arch encircling the trachea and oesophagus causing compression of these structures (Fig. 5.21). A right aortic arch combined with an aberrant subclavian artery passing behind the oesophagus with a duct or ligament can also complete a ring. Vascular rings can be associated with other cardiac lesions, typically VSD or conotruncal abnormalities. Vascular slings occur when the aberrant vasculature partially surrounds the trachea and oesophagus. The left pulmonary artery may arise from the right pulmonary artery and compress the trachea (Fig. 5.22). Sometimes there may be severe tracheal abnormalities including complete tracheal rings, which may need extensive tracheal reconstruction. An isolated aberrant subclavian artery is very common in normal children and is very rarely responsible for feeding problems.
Comparative study between multi-detector computed tomography and echocardiography in evaluation of congenital vascular rings
Published in Alexandria Journal of Medicine, 2018
Manal Hamisa, Fatma Elsharawy, Wafaa Elsherbeny, Suzan Bayoumy
All patients underwent echocardiography using (vivid 7, GE, Hortin Norway using probe 5S MHZ), patients under 4 years were sedated using chloral hydrate (1 mg/kg), patients were examined in reclining position and complete study for cardiac structure were done. The transducer is positioned at first at suprasternal notch, starting show downward angulation then sweep upward to allow identification of aortic arch position and its relation to trachea and branching of great vessels of head and neck. In left aortic arch, the first branch heads to the right and then bifurcates into right subclavian and right common carotid arteries. While in (right aortic arch with mirror-image branching) the first branch was seen to head to the left and then bifurcates into left subclavian and left common carotid arteries. An (aberrant subclavian artery) should be suspected if the first branch does not bifurcate. In (double aortic arch) if both archs are patent so we can detected them in transverse suprasternal view. From parasternal short axis- views at level of bifurcation of pulmonary artery and at supra sternal view, echocardiography can reveal continuation of pulmonary trunk to right and when we cannot see the origin of left pulmonary artery we must suggest either absence or aberrant origin of left pulmonary artery. Pulmonary sling is seen when the origin of left pulmonary artery arises from the right pulmonary artery, it is suggested when pulmonary trunk is followed to the right side. However information taken by echocardiography examination is inadequate, and also evaluation of the anatomy of the airways is difficult by ultrasound.
Dysphagia lusoria in a young woman with chest pain
Published in Baylor University Medical Center Proceedings, 2022
Busara Songtanin, Roy Jacob, Neha Mittal
Dysphagia lusoria (from Latin lusus naturae, freak of nature) was first described in 1761 by surgeon David Bayford, who discovered a fatal case of obstructed deglutition.1 Dysphagia lusoria is a congenital abnormality of the aortic arch characterized by an aberrant subclavian artery that compresses the esophagus and causes dysphagia. An aberrant right subclavian artery occurs more often than an aberrant left subclavian artery. This right subclavian artery anomaly occurs in 0.4% to 1.8% of the population and is characterized by absence of the brachiocephalic trunk and a right subclavian artery that arises directly from the aortic arch instead of originating from the brachiocephalic artery, crosses the midline, and compresses the esophagus.