Cardiovascular ImagingDouble aortic arch
aortic arch anomaly in which the ascending
aorta divides into right and left aortic arches which join posteriorly to form the descending
aorta. Each arch provides separate origin to the ipsilateral common carotid and subclavian arteries. In about 85% of cases the right arch is the larger. It constitutes a
vascular ring around the trachea and
oesophagus and almost invariably produces severe airway compression during infancy. Plain radiography can display the bilateral aortic arches and indentation of the trachea.
Barium swallow demonstrates bilateral impressions on the
oesophagus with the right one larger and higher. Definitive diagnosis is established with
thoracic aortography,
CT and
MRI.
MRI in the
transverse and
sagittal planes clearly shows the severity of airway compression and size of the two arches (
Fig.1).
CBH
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Spin echo MR image demonstrates a double aortic arch with narrowing of the trachea. The right arch is larger and the left arch has a severe stenosis posteriorly (arrow).
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Double aortic arch, Fig.1 | |