Int J Cardiovasc Imaging DOI 10.1007/s10554-014-0391-2
CASE-IN-POINT
Right aortic arch with aberrant left subclavian artery and coarctation Shilpa Hegde • Bruce Greenberg
Received: 6 February 2014 / Accepted: 25 February 2014 Ó Springer Science+Business Media Dordrecht 2014
Case Summary: A 12 year old girl presented to ‘well child clinic’ prior to sports participation with symptoms of occasional leg pain while running. A grade 2–3/4 murmur was present. Right upper extremity hypertension was present with the arm pressure measuring 159/68 mm Hg. Asymmetric extremity pulses were present with weak pulses in the left radial artery and bilateral dorsalis pedis pulses. A right aortic arch and coarctation was detected by echocardiography and MRI. MRI also detected a diverticulum of Kommerell and aberrant left subclavian artery (Fig. 1).
Discussion: A right aortic arch is found in 0.1 % of the population. Ten patients (4 %) in a series of 240 patients with right aortic arch had coarctation, 6 of the ten also had an aberrant left subclavian artery [1]. Kommerell in 1936 described the aortic diverticulum associated with an aberrant right subclavian artery, from a left arch [2]. Kommerell’s diverticulum however can be associated with various anomalies of the aortic arch but is most frequent in cases of right arch with aberrant left subclavian artery [2]. Congenital heart defects associated with a right arch and coarctation include ventricular septal defect, double outlet right ventricle and pulmonary valve abnormalities [1].
S. Hegde (&) B. Greenberg Little Rock, AR, USA e-mail: [email protected]
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Int J Cardiovasc Imaging Conflict of interest
None.
References 1. Ismat FA, Weinberg PM, Rychik J, Karl TR, Fogel MA (2006) Right aortic arch and coarctation: a rare association. Congenit Heart Dis. 1(5):217–223 2. van Son JA, Konstantinov IE (2002) Burckhard F. Kommerell and Kommerell’s diverticulum. Tex Heart Inst J 29(2):109–112
Fig. 1 A dorsal view of a gadolinium enhanced MRA shows a right aorta arch with a diverticulum of Kommerell (arrow) and aberrant left subclavian artery. Coarctation (block arrow) proximal to the diverticulum is present
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CASE-IN-POINT
Right aortic arch with aberrant left subclavian artery and coarctation Shilpa Hegde • Bruce Greenberg
Received: 6 February 2014 / Accepted: 25 February 2014 Ó Springer Science+Business Media Dordrecht 2014
Case Summary: A 12 year old girl presented to ‘well child clinic’ prior to sports participation with symptoms of occasional leg pain while running. A grade 2–3/4 murmur was present. Right upper extremity hypertension was present with the arm pressure measuring 159/68 mm Hg. Asymmetric extremity pulses were present with weak pulses in the left radial artery and bilateral dorsalis pedis pulses. A right aortic arch and coarctation was detected by echocardiography and MRI. MRI also detected a diverticulum of Kommerell and aberrant left subclavian artery (Fig. 1).
Discussion: A right aortic arch is found in 0.1 % of the population. Ten patients (4 %) in a series of 240 patients with right aortic arch had coarctation, 6 of the ten also had an aberrant left subclavian artery [1]. Kommerell in 1936 described the aortic diverticulum associated with an aberrant right subclavian artery, from a left arch [2]. Kommerell’s diverticulum however can be associated with various anomalies of the aortic arch but is most frequent in cases of right arch with aberrant left subclavian artery [2]. Congenital heart defects associated with a right arch and coarctation include ventricular septal defect, double outlet right ventricle and pulmonary valve abnormalities [1].
S. Hegde (&) B. Greenberg Little Rock, AR, USA e-mail: [email protected]
123
Int J Cardiovasc Imaging Conflict of interest
None.
References 1. Ismat FA, Weinberg PM, Rychik J, Karl TR, Fogel MA (2006) Right aortic arch and coarctation: a rare association. Congenit Heart Dis. 1(5):217–223 2. van Son JA, Konstantinov IE (2002) Burckhard F. Kommerell and Kommerell’s diverticulum. Tex Heart Inst J 29(2):109–112
Fig. 1 A dorsal view of a gadolinium enhanced MRA shows a right aorta arch with a diverticulum of Kommerell (arrow) and aberrant left subclavian artery. Coarctation (block arrow) proximal to the diverticulum is present
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