![]() It is also frequently seen in patients with Tetralogy of Fallot and Truncus Arteriosus.Īn isolated right aortic arch often does not cause any symptoms on its own. Right aortic arch can be seen in conjunction with genetic abnormalities such as DiGeorge syndrome (22q11 deletion). With increased prenatal screening and advances in technology, it is believed it will become even more common. It is thought that 1 in every 1,000 people has a right aortic arch. If the process is reversed, the right aortic arch becomes the dominant arch. The right aortic arch usually regresses to a smaller vessel supplying the right arm, leaving the left aortic arch as the main arch. Initially, there are paired aortic arches, both right and left. The development of the aortic arch happens as early as three to four weeks into the pregnancy. The arch has three branches that carry blood to the upper portion of the body, including the head, neck and arms. The aorta forms an aortic arch along the top of the heart as it travels to the body. The aorta is the large artery that carries oxygenated blood out of the heart. doi:10.1148/rg.Right aortic arch is a heart condition in which the aortic arch develops on the right side of the airway instead of the left side. Congenital Variants and Anomalies of the Aortic Arch. (2019) The Korean journal of internal medicine. Kommerell's diverticulum: a rare cause of esophageal subepithelial lesion. Kommerell's diverticulum and right-sided aortic arch: a cohort study and review of the literature. Cinà CS, Althani H, Pasenau J, Abouzahr L. (2015) General thoracic and cardiovascular surgery. Kommerell's diverticulum in the current era: a comprehensive review. Surgical treatment of Kommerell's diverticulum and other saccular arch aneurysms. Surgical treatment for Kommerell's diverticulum. Rings, slings, and other things: vascular compression of the infant trachea updated from the midcentury to the millennium-the legacy of Robert E. Right-sided aortic arch with Kommerell's diverticulum: 64-DCTA with 3D reconstructions. It is named after Burckhard F Kommerell, a German radiologist (1901-1990) who first described it in 1936 8. The major complications of Kommerell diverticulum are rupture or dissection 7. Many consider surgical intervention once the diameter of the diverticulum orifice exceeds 30 mm, and/or the diameter of the descending aorta adjacent to the diverticulum exceeds 50 mm 8. Options include aortic replacement or thoracic endovascular stent-graft replacement (TEVAR), and extra-anatomic bypass of the aberrant subclavian artery 6,7. Given the rarity of this condition, there is no established management guideline. Conversely, if the subclavian artery is normal caliber at the base then the ductus / ligament is located on the same side as the arch and no vascular ring is present 8,11. If the diameter of the bulbous diverticulum is 1.5 times greater at the base than in the distal subclavian artery then the ductus arteriosus / ligamentum arteriosum is located on the opposite side of the arch, forming a vascular ring. Typically shows bulbous enlargement of the proximal subclavian artery at its origin from the aortic arch, posterior to the esophagus. On a barium swallow, an impression can be seen from the left side of the esophagus simulating a double aortic arch. On chest radiographs, a small rounded density may be seen laterally towards the left of the trachea. It is considered a developmental error with a remnant of the fourth dorsal aortic arch. Recent histological studies have suggested the presence of cystic medial necrosis in the diverticulum wall. Presentation in childhood can often be with airway symptoms whereas dysphagia and chest discomfort can be more common in the adult presentation. Kommerell diverticulum may be asymptomatic or cause symptoms of esophageal or tracheal obstruction. ![]() in 20-60% of people with aberrant subclavian arteries are associated with Kommerell’s diverticulum 10. The prevalence of aberrant right and left subclavian arteries is approximately 0.7-2% and 0.04-0.4% of the population respectively 10. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |