The compressive segment was 25 mm long and 12 mm wide and it had a lumen. 1c arrow) was positioned very deep, as the descending thoracic aorta was on the dorsal right. However, the site where the descending thoracic aorta connected with the left-sided aortic arch (Fig. The compressive segment between the left subclavian artery and the right-sided descending thoracic aorta could easily be identified (Fig. A chest radiography of the posteroanterior projection shows an aortic knob projecting over the right side of the upper manubrium ( f).Īt the right-side decubitus position (60°), left third intercostal space thoracotomy was performed. A 3D CT scan shows the site at which the oesophagus is compressed by the compressive segment ( e). The postoperative 3D CT scan clearly shows the site at which the left aortic arch is divided ( d). The 3D CT scan shows the anatomy of the DAA more clearly, and the white arrow indicates the site at which the descending thoracic aorta is connected to the left-sided aortic arch ( c). The patient elected to undergo surgery.Ĭontrast-enhanced CT showing a DAA involving a complete vascular ring around the trachea and oesophagus ( a and b). ![]() ![]() We assumed that the left-sided aortic arch had a compressive segment between the left subclavian artery and the right-sided descending thoracic aorta. The right subclavian and right common carotid arteries originated from the right aortic arch, whereas the left common carotid and left subclavian arteries originated from the left aortic arch the diameters of the aortic arches were 24 mm (right) and 14 mm (left). 1c) and the site of oesophageal compression more clearly (Fig. Three-dimensional (3D) CT demonstrated the anatomy of the DAA (Fig. Esophagogastroduodenoscopy revealed no oesophageal lesions, and subsequent computed tomography (CT) scanning revealed a DAA in the form of a complete vascular ring around the trachea and oesophagus of the right and left aortic arches (Fig. Chest radiography showed an aortic knob projecting over the right side of the upper manubrium (Fig. The results of physical examination and laboratory evaluation were normal. He had been asymptomatic and in excellent health until ∼6 months before he was referred to our hospital. A 60-year old man visited our hospital because of severe dysphagia.
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