Clinical and Imaging Findings of Symptomatic Right Aortic Arch and Double Aortic Arch: Case Report

Aim: Anomalies of aortic arch are uncommon, accounting for only 1-3% of all congenital cardiac diseases. A vascular ring results from the abnormal development of an aortic arch complex. Generally, it manifests with tracheoesophageal compression symptoms during infancy. We aimed to discuss clinical and imaging findings of two cases of vascular ring based on existing literature.

Cases: This article presents two cases of a 4-year-old child diagnosed with right sided aortic arch and a new-born child diagnosed with double aortic arch in neonatal unit. The first patient presented with complaints of coughing, wheezing and shortness of breath, the second patient suffered from respiratory distress. In the both cases, diagnosis were established using multi-detector computed tomography (MDCT). Both patients were diagnosed with vascular ring, considering their existing findings, and referred for surgery.

Discussion: Apparent airway obstructions lead to critical complaints at early ages. Moderately severe symptoms and the non-existence of anatomic compression may cause resulting diseases to be diagnosed in a later period of life. A vascular ring can be diagnosed using chest radiography, barium oesophagus graphy, transthoracic echocardiography, MDCT, magnetic resonance imaging and angiography. However, pathologies of the studied cases (right aortic arch, double aortic arch, and tracheal compression) are effectively observed with MDCT and using the post-processing images of MDCT.

Conclusion: A vascular ring should be considered in the event of recurrent lung infections, unexplained coughs, wheezing and stridor during childhood as well as in the case of unexplained respiratory distress in new-born children. MDCT is an excellent modality for patients suspected of having a vascular ring.