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Diagnostic and Therapeutic Considerations

Howard K. Leonardi, MD; Charles Z. Naggar, MD; F. Henry Ellis, Jr, MD, PhD

Arch Surg. 1980;115(10):1229-1232.

Abstract
• An unusual aortic arch anomaly produced dysphagia in a previously healthy man. Aortography performed simultaneously with a barium esophagogram disclosed a right aortic arch and right descending aorta. Esophageal compression was caused by a retroesophageal aortic diverticulum that emerged from the descending aorta and gave rise to the left subclavian artery. A left ligamentum arteriosum connected the proximal left subclavian artery and the left pulmonary artery, thus completing a vascular ring encircling the esophagus. Surgical correction was accomplished using a left thoracotomy. Division of the ligamentum as well as the junction of the aortic diverticulum and left subclavian artery freed the esophagus from its circumferential constrictions and relieved the patient's dysphagia.

(Arch Surg 115:1229-1232, 1980)

Author Affiliations
From the Overholt Thoracic Clinic (Dr Leonardi); New England Deaconess Hospital (Drs Leonardi and Ellis); and the Department of Thoracic and Cardiovascular Surgery (Dr Ellis) and the Section of Cardiovascular Diseases (Dr Naggar), Lahey Clinic Foundation, Boston.

Footnotes
Accepted for publication March 26, 1980.

Read before the annual meeting of the New England Society for Vascular Surgery, Waterville Valley, NH, Sept 27, 1979.

Reprint requests to Overholt Thoracic Clinic, 135 Francis St, Boston, MA 02215 (Dr Leonardi).

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