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Joseph Junewick, MD FACR
over 10 years ago
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Circumflex Retroesophageal Right Aortic Arch

Case Detail

Anatomy: Vascular-Lymphatic
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 9 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: CT
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17 month old male with difficulty breathing.

Case Images


Circumflex Retroesophageal Right Aortic Arch


CT- Axial image shows right aortic arch extending to the left behind the esophagus. Also note the subcutaneous hemangioma anterior to the sternum and nodular infiltrate in the right upper lobe. Volume rendered image shows the corcumflex right aortic arch and tracheal stenosis.


Right aortic arch has been classified into various types: 1) Right aortic arch with aberrant left subclavian artery is the most common and is not associated with congenital heart disease. The order of brachiocephalic artery origin is the left common carotid artery followed by the right carotid, right subclavian, and left subclavian arteries. The right arch passes between the superior vena cava and right side of the trachea and esophagus, crossing over the right main-stem bronchus to join the descending aorta. 2) The right arch maintains a position to the right of the esophagus and descends on the right side of the spine. 3) The right arch passes behind the esophagus to turn abruptly downward, descending usually on the right side or near the midline. 4) Infrequently, the right arch crosses the midline behind the esophagus to descend on the left side of the spine, resulting in the circumflex retroesophageal right aortic arch. The impression upon the posterior esophagus on barium examination is more pronounced than that encountered with an abberent subclavian artery.


Shuford WH, Sybers RG, Gordon IJ et al. Circumflex Retroesophageal Right Aortic Arch Simulating Mediastinal Tumor or Dissecting Aneurysm. AJR (1986); 146:491-496.

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