Clinical and Radiological Features of Patients with Right Aortic Arch

Abstract

The aim of this study was to evaluate the clinical and radiological features of the patients with right aortic arch who were diagnosed in our clinic between July 1st, 1998 and December 31st, 2003. The files and records of 13524 patients seen in our clinic were retrospectively reviewed to identify the patients and all the data including demographic characteristics, history, physical examination findings, radiological findings, results of spirometric studies and bronchoscopies. Eight patients (0.06%) were diagnosed as having right aortic arch and comprised the study group. The study group included 6 male and 2 female patients aged 25 to 70 years with a mean age of 45. Four patients were symptomatic. Among them, two patients presenting with effort dyspnea and one patient suffering from dry cough had been diagnosed as bronchial asthma and had been receiving relevant treatment. At the end of radiographic, spirometric and bronchoscopic studies it was understood that their clinical pictures were due to compression of trachea and right main bronchial system by right aortic arch and its components. Symptoms of one symptomatic patient were due to small cell lung cancer. On thoracic computed tomography, the subtype of right aortic arch was identified as right aortic arch with anomalous left subclavian artery in seven patients (87.5%) and right aortic arch with mirror image branching in one patient. In our study, right aortic arch was diagnosed in 0.06% of the patients seen in our clinic, a ratio that is lower than reported in the literature. Right aortic arch with anomalous left subclavian artery was the predominant type of right aortic arch. Although it was reported in the literature that right aortic arch rarely causes symptoms in adult population, it caused symptoms in three of the eight patients (37.5%). Therefore, we suggest that differential diganosis of the patients presenting with effort dyspnea and dry cough must include right aortic arch.