International Journal of Morphology
On-line version ISSN 0717-9502
DANIEL ALGIERI, Rubén; MAZZOGLIO Y NABAR, Martín Javier and FERRANTE, María Soledad. Retroesophageal Variation of the Aortic Arch. Int. J. Morphol. [online]. 2008, vol.26, n.2, pp. 337-343. ISSN 0717-9502. http://dx.doi.org/10.4067/S0717-95022008000200015.
Classical literature does not mention the frequency of vascular thoracic changes. Nevertheless, these abnormalities are frequent, being able to exist without producing symptoms neither to require treatment. The retroesophageal aortic arch can be presented to the right (AARED) or left of the trachea and esophagus and cause symptoms of compression by means of a partial or complete vascular ring. It can be accompanied by abnormalities of the Subclavian Artery. In 1735 Hunauld reports the first case of aberrant Subclavian Artery, later, Hommel publishes a double aortic arch and in 1794 Bayford describes the "obstructive dysphagia lusoria". The aim was an anatomical description and a clinical and surgical correlate of a variation of the aortic arch such as an AARED. Cervicothoracical dissection of a adultmale corpse with AARED found during theperiod 03/1998-03/2006, on 95 dissections formolized at 10%. Results: In the AARED, the ascending aorta elapses on the right side of the esophagus and the trachea crossing over the main-stem bronchus, the arch crosses behind the esophagus and descends on the left side. Together with the arterial ligament, they form a vascular ring that wraps both the trachea and esophagus. Conclusions: The dissected corpse presents an AARED with a complete vascular ring and a right retroesophageal Subclavian Artery. These variations can be revealed by diagnostic imaging (esophagogram, angiography or computed tomography with or without 3-dimensional reconstruction) before the presence of a syndrome by esophagus-tracheal compression. The knowledge of these anomalies are extremely important for the surgeon in mediastinal approaches by the cervical way or in the urgency of a thoracic trauma.
Keywords : Variations of the aortic arch; Retroesophageal aortic arch; Vascular ring; Retroesophageal subclavian Artery.