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Right Aortic Arch
Santiago Martínez-Jiménez, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Right aortic arch (RAA)
          • Synonyms

            • Right arch
          • Definitions

            • Aortic arch located to right of trachea, crossing right main-stem bronchus
            • Common variations
              • RAA with aberrant left subclavian artery (ALSA) ± Kommerell diverticulum (KD)
                • KD
                  • Saccular dilatation at level of ALSA
                  • Implies ligamentum arteriosum and vascular ring
              • RAA with mirror-image branching
            • Uncommon variations
              • RAA with left descending aorta (circumflex aorta)
              • RAA with isolation of left subclavian artery
              • RAA with aberrant brachiocephalic artery
              • RAA with unilateral absence of pulmonary artery

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Muraoka M et al: High incidence of progressive stenosis in aberrant left subclavian artery with right aortic arch. Heart Vessels. 33(3):309-315, 2018
                                          2. Arazińska A et al: Right aortic arch analysis: anatomical variant or serious vascular defect? BMC Cardiovasc Disord. 17(1):102, 2017
                                          3. Hanneman K et al: Congenital variants and anomalies of the aortic arch. Radiographics. 37(1):32-51, 2017
                                          4. Tanaka A et al: Kommerell's diverticulum in the current era: a comprehensive review. Gen Thorac Cardiovasc Surg. 63(5):245-59, 2015
                                          5. Etesami M et al: Computed tomography in the evaluation of vascular rings and slings. Insights Imaging. 5(4):507-21, 2014
                                          6. Kanne JP et al: Right aortic arch and its variants. J Cardiovasc Comput Tomogr. 4(5):293-300, 2010
                                          7. Türkvatan A et al: Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol. 10(2):176-84, 2009
                                          8. Holmes KW et al: Magnetic resonance imaging of a distorted left subclavian artery course: an important clue to an unusual type of double aortic arch. Pediatr Cardiol. 27(3):316-20, 2006
                                          9. Weinberg PM: Aortic arch anomalies. J Cardiovasc Magn Reson. 8(4):633-43, 2006
                                          10. Knight L et al: Right aortic arch. Types and associated cardiac anomalies. Circulation. 50(5):1047-51, 1974
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Right aortic arch (RAA)
                                                  • Synonyms

                                                    • Right arch
                                                  • Definitions

                                                    • Aortic arch located to right of trachea, crossing right main-stem bronchus
                                                    • Common variations
                                                      • RAA with aberrant left subclavian artery (ALSA) ± Kommerell diverticulum (KD)
                                                        • KD
                                                          • Saccular dilatation at level of ALSA
                                                          • Implies ligamentum arteriosum and vascular ring
                                                      • RAA with mirror-image branching
                                                    • Uncommon variations
                                                      • RAA with left descending aorta (circumflex aorta)
                                                      • RAA with isolation of left subclavian artery
                                                      • RAA with aberrant brachiocephalic artery
                                                      • RAA with unilateral absence of pulmonary artery

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • Fluoroscopic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Echocardiographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Muraoka M et al: High incidence of progressive stenosis in aberrant left subclavian artery with right aortic arch. Heart Vessels. 33(3):309-315, 2018
                                                                                  2. Arazińska A et al: Right aortic arch analysis: anatomical variant or serious vascular defect? BMC Cardiovasc Disord. 17(1):102, 2017
                                                                                  3. Hanneman K et al: Congenital variants and anomalies of the aortic arch. Radiographics. 37(1):32-51, 2017
                                                                                  4. Tanaka A et al: Kommerell's diverticulum in the current era: a comprehensive review. Gen Thorac Cardiovasc Surg. 63(5):245-59, 2015
                                                                                  5. Etesami M et al: Computed tomography in the evaluation of vascular rings and slings. Insights Imaging. 5(4):507-21, 2014
                                                                                  6. Kanne JP et al: Right aortic arch and its variants. J Cardiovasc Comput Tomogr. 4(5):293-300, 2010
                                                                                  7. Türkvatan A et al: Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol. 10(2):176-84, 2009
                                                                                  8. Holmes KW et al: Magnetic resonance imaging of a distorted left subclavian artery course: an important clue to an unusual type of double aortic arch. Pediatr Cardiol. 27(3):316-20, 2006
                                                                                  9. Weinberg PM: Aortic arch anomalies. J Cardiovasc Magn Reson. 8(4):633-43, 2006
                                                                                  10. Knight L et al: Right aortic arch. Types and associated cardiac anomalies. Circulation. 50(5):1047-51, 1974