Dysphagia after arteria lusoria dextra surgery: Anatomical c
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Aberrant right subclavian artery is the most common congenital root anomaly in general population with a prevalence ranging from 0.5% to 1.8%. The arteria lusoria was first described in 1794 by David Bayford; it results from an atypical obliteration of the 4th aortic arch, whereby the right subclavian artery is formed by the persistent right dorsal aorta in connection with the 7th intersegmental artery. The resulting aberrant right subclavian artery has an atypical origin from the descending aorta and reveals a retro-esophageal course to supply the right arm with blood.
The aberrant right subclavian artery usually remains asymptomatic. Nevertheless 20%-40% of patients have tracheo-esophageal symptoms, with dysphagia being the most frequent symptom in 90% of patients with clinical symptoms. Respiratory symptoms like cough, dyspnea, stridor, increased respiratory infections or thoracic pain are more frequent in children than in adults.
Surgical treatment should be restricted to seriously symptomatic patients and is usually performed via right-sided thoracotomy. This operative intervention consists of mobilization and transection of the aberrant right subclavian artery from the descending aorta, and re-implantation into the right common carotid artery.

Case Report:
A 6-year-old girl presented with recurrent and progressive dysphagia over 4 wk. At first contact, she had lost 8 kg over 4 wk, showed severe difficulty swallowing solid foods and also suffered from recurrent thoracic pain. She underwent a barium swallow for differential diagnosis purposes which demonstrated a severe compression of the esophagus in its intermediate third, highly suspicious of vascular compression. Subsequent echocardiography led to the presumptive diagnosis of an aberrant right subclavian artery with its origin in the descending aorta and a retro-esophageal course to the right side. The authors also diagnosed a truncus bicaroticus. Subsequent MRA confirmed the diagnosis of an isolated arteria lusoria, which was considered as the proven cause for the girl’s dysphagia.....