CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 11Major Anomalies of the Aortic
Arch and Pulmonary Artery

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig CA 11-1 Right aortic arch with aberrant left subclavian artery. (A)
Frontal view from an esophagram demonstrates the right aortic
arch (arrow). (B) Oblique posterior impression on the esophagus
(arrow) represents the aberrant left subclavian artery as it courses
to reach the left upper extremity.

4. • Fig CA 11-2 Cervical aortic arch. (A) Posterior
esophageal impression (arrow) is caused by the
retroesophageal course of the distal arch or the
proximal descending aorta. (B) Subtraction film from
an aortogram demonstrates the aortic arch extending
into the neck (arrow).

5. • Fig CA 11-3 Double aortic arch. Characteristic
reverse S-shaped indentation on the
esophagus (arrows). As usual, the right
(posterior) arch is higher and larger than the
left (anterior) arch.6

6. • Fig CA 11-4 Aberrant right subclavian artery. (A)
Lateral view from an esophagram demonstrates a
posterior esophageal impression (arrow). (B) On a
frontal view, the esophageal impression (arrow)
runs obliquely upward and to the right. (C)
Subtraction film from an arteriogram shows the
aberrant vessel (arrows) arising distal to the left
subclavian artery.

7. • Fig CA 11-5 Aberrant left pulmonary artery. Lateral
esophagram demonstrates the characteristic
indentation of the anterior wall of the esophagus. Note
the posterior impression and anterior displacement of
the trachea (arrows) caused by the aberrant artery.11