Right aortic arch

Ingrid Witters, MD

Gynaecologe, Docente Opleiding Vroedkunde, Hogeschool Hasselt, Academisch Personeel Menselijke Erfelijkheid KU, Leuven, Belgium

Address correspondence to Ingrid Witters, Center for Human Genetics, Herestraat 49, 3000 Leuven, Belgium

Case report

A primigravida was seen for fetal anatomical screening at 20 weeks. Transverse section of the upper mediastinum revealed a vascular paratracheal structure with right aortic arch (Figure 1).This is the "U" shape configuration. No additional malformations were seen. Amniocentesis showed a normal karyotype, 46XX and no deletion 22q11. After birth at 39 weeks, prenatal finding was confirmed: right aortic arch with left ductus and aberrant left subclavian artery forming a vascular ring. A barium esophagogram (Figure 2) showed an impression on the posterior part of the esophagus with normal passage. Due to progressive respiratory problems with rattling respiration and nightly coughing, the ligamentum arteriosum was transected at the age of 11 months. Since, she"s doing fine.

Figures 1, 2: Prenatal color Doppler ultrasound image showing transverse section of the upper mediastinum with a vascular paratracheal structure representing right aortic arch (left); and a postnatal barium esophagogram showing an impression on the posterior part of the esophagus with normal passage (right).

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