Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T07:36:29.702Z Has data issue: false hasContentIssue false
  • English
  • Français

Anatomic classification of the right aortic arch

Published online by Cambridge University Press:  28 October 2020

Sudesh Prabhu Open the ORCID record for Sudesh Prabhu [Opens in a new window] ,
Siddhant Mehra ,
Srikanth Kasturi ,
Rishi Tiwari ,
Abhijit Joshi ,
Colin John  and
Tom R. Karl
Sudesh Prabhu*
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Siddhant Mehra
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Srikanth Kasturi
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Rishi Tiwari
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Abhijit Joshi
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Colin John
Affiliation:
Department of Paediatric Cardiac Surgery, Narayana Institute of Cardiac Sciences, Bengaluru, India
Tom R. Karl
Affiliation:
European Journal of Cardio-Thoracic Surgery, Windsor, UK
*
Author for correspondence: S. Prabhu, Consultant Paediatric Cardiac Surgeon, Narayana Institute of Cardiac Sciences, 258/A Hosur Road, Bommasandra Industrial Area, Anekal Taluk, Bengaluru 560099, Karnataka, India. Tel: +91 9886899450. E-mail: sudesh006@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

The term right aortic arch is used for an aorta that arches over the right bronchus. Right aortic arch was classified into two types by Felson et al, based on branching patterns, with a proposed embryological explanation, and into three types by Shuford et al. Other anatomical variants of right aortic arch were described later, including isolated left brachiocephalic artery and aberrant left brachiocephalic artery. We have classified right aortic arch anatomy into 10 variants, supported by radiological evidence, and with reference to possible embryology. This classification will help in understanding the morphological basis for the formation of different types of right aortic arch and the course of the recurrent laryngeal nerve in such cases.

Keywords

Right aortic archembryology of aortic archRathke’s aortic arch diagramEdwards’s double aortic arch conceptcourse of laryngeal nerve
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1694 - 1701
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Liechty, JD, Shields, TW, Anson, BJ. Variations pertaining to the aortic arches and their branches; with comments on surgically important types. Q Bull Northwest Univ Med Sch 1957; 31: 136–143.Google ScholarPubMed
Hastreiter, AR, D’Cruz, IA, Cantez, T, Namin, EP, Licata, R. Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J 1966; 28: 722–739. doi: 10.1136/hrt.28.6.722 CrossRefGoogle ScholarPubMed
Felson, B, Palayew, MJ. The two types of right aortic arch. Radiology 1963; 81: 745–759. doi: 10.1148/81.5.745 CrossRefGoogle ScholarPubMed
Shuford, WH, Sybers, RG, Edwards, FK. The three types of right aortic arch. Am J Roentgenol Radium Ther Nucl Med 1970; 109: 67–74. doi: 10.2214/ajr.109.1.67 CrossRefGoogle ScholarPubMed
Mart, CR, Zachary, CH, Kupferschmid, JP, Weber, HS. Tetralogy of Fallot with right aortic arch and isolation of the left innominate artery from a left-sided patent ductus arteriosus. Pediatr Cardiol 2001; 22: 58–59. doi: 10.1007/s002460010154 CrossRefGoogle ScholarPubMed
Bein, S, Saba, Z, Patel, H, Reinhartz, O, Hanley, FL. Coarctation of the aorta in the right aortic arch with left aberrant innominate artery. Pediatr Cardiol 2006; 27: 621–623. doi: 10.1007/s00246-006-1327-y CrossRefGoogle ScholarPubMed
Banka, P, Geva, T, Powell, AJ, Geggel, R, Lahiri, T, Valente, AM. Images in cardiovascular medicine. Right aortic arch with aberrant left innominate artery: a rare vascular ring. Circulation 2009; 120: 264–265. doi: 10.1161/CIRCULATIONAHA.109.851733 CrossRefGoogle ScholarPubMed
Mangukia, C, Sethi, S, Agarwal, S, Mishra, S, Satsangi, DK. Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect. Ann Pediatr Cardiol 2014; 7: 148–151. doi: 10.4103/0974-2069.132500 CrossRefGoogle Scholar
Prabhu, S, Kasturi, S, Mehra, S, et al. The aortic arch in tetralogy of Fallot: types of branching and clinical implications. Cardiol Young 2020. doi: 10.1017/S1047951120001705 CrossRefGoogle ScholarPubMed
Edwards, JE. Anomalies of the derivatives of the aortic arch system. Med Clin North Am 1948; 32: 925–949. doi: 10.1016/s0025-7125(16)35662-0 CrossRefGoogle ScholarPubMed
Graham, A, Poopalasundaram, S, Shone, V, Kiecker, C. A reappraisal and revision of the numbering of the pharyngeal arches. J Anat 2019; 235: 1019–1023. doi: 10.1111/joa.13067 CrossRefGoogle ScholarPubMed
Knight, L, Edwards, JE. Right aortic arch: types and associated cardiac anomalies. Circulation 1974; 50: 1047–1051. doi: 10.1161/01.cir.50.5.1047 CrossRefGoogle ScholarPubMed
Myers, PO, Fasel, JH, Kalangos, A, Gailloud, P. Arteria lusoria: developmental anatomy, clinical, radiological and surgical aspects. Ann Cardiol Angeiol (Paris) 2010; 59: 147–154. doi: 10.1016/j.ancard.2009.07.008 CrossRefGoogle ScholarPubMed
Velasquez, G, Nath, PH, Castaneda-Zuniga, WR, Amplatz, K, Formanek, A. Aberrant left subclavian artery in tetralogy of Fallot. Am J Cardiol 1980; 45: 811–818. doi: 10.1016/0002-9149(80)90126-5 CrossRefGoogle ScholarPubMed
Agati, S, Guerra Sousa, C, Calvaruso, FD, et al. Airway compression by a right aortic arch in the absence of a vascular ring. World J Pediatr Congenit Heart Surg 2019; 10: 103–104. doi: 10.1177/2150135118802787 CrossRefGoogle ScholarPubMed
Lee, JY, Won, DY, Oh, SH, et al. Three concurrent variations of the aberrant right subclavian artery, the non-recurrent laryngeal nerve and the right thoracic duct. Folia Morphol (Warsz) 2016; 75: 560–564. doi: 10.5603/FM.a2016.0025 CrossRefGoogle ScholarPubMed
Natsis, K, Lazaridis, N, Gkiouliava, A, Didagelos, M, Piagkou, M. Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature. Folia Morphol (Warsz) 2016; 75: 130–135. doi: 10.5603/FM.a2015.0080 CrossRefGoogle ScholarPubMed
Pisanu, A, Pili, S, Uccheddu, A. Non-recurrent inferior laryngeal nerve. Chir Ital 2002; 54: 7–14.Google ScholarPubMed
Page, C, Monet, P, Peltier, J, Bonnaire, B, Strunski, V. Non-recurrent laryngeal nerve related to thyroid surgery: report of three cases. J Laryngol Otol 2008; 122: 757–761. doi: 10.1017/S0022215107008389 CrossRefGoogle ScholarPubMed
Natsis, K, Didagelos, M, Gkiouliava, A, Lazaridis, N, Vyzas, V, Piagkou, M. The aberrant right subclavian artery: cadaveric study and literature review. Surg Radiol Anat 2017; 39: 559–565. doi: 10.1007/s00276-016-1796-5 CrossRefGoogle ScholarPubMed
Masuoka, H, Miyauchi, A, Higashiyama, T, Yabuta, T, Kihara, M, Miya, A. Right-sided aortic arch and aberrant left subclavian artery with or without a left nonrecurrent inferior laryngeal nerve. Head Neck 2016; 38: E2508–E2511. doi: 10.1002/hed.24492 CrossRefGoogle ScholarPubMed
Kouchoukos, NT, Blackstone, EH, Hanley, FL, Kirklin, JK. Ventricular septal defect with pulmonary stenosis or atresia. In: Kirklin/Barratt-Boyes Cardiac Surgery. Saunders, Elsevier Inc., Philadelphia, PA, 2013: 1372.Google Scholar
Bamforth, SD, Chaudhry, B, Bennett, M, et al. Clarification of the identity of the mammalian fifth pharyngeal arch artery. Clin Anat 2013; 26: 173–182. doi: 10.1002/ca.22101 CrossRefGoogle ScholarPubMed
Gupta, SK, Gulati, GS, Anderson, RH. Clarifying the anatomy of the fifth arch artery. Ann Pediatr Cardiol 2016; 9: 62–67. doi: 10.4103/0974-2069.171392 CrossRefGoogle ScholarPubMed