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Editorial
. 2021 Dec;16(4):717-722.
doi: 10.26574/maedica.2020.16.4.717.

Prenatal Ultrasound Diagnosis of Double Aortic Arch versus Right Aortic Arch Variant in Vascular Ring Formation - Case Report and Review of the Literature

Roxana Elena Bohiltea  1 , Paul Costin Pariza  1 , Irina Stavarache  2 , Octavian Munteanu  3 , Vlad Dima  4 , Bianca Margareta Mihai  4 , Tiberiu Augustin Georgescu  5 , Eliza Cinteza  6
Affiliations
Editorial

Prenatal Ultrasound Diagnosis of Double Aortic Arch versus Right Aortic Arch Variant in Vascular Ring Formation - Case Report and Review of the Literature

Roxana Elena Bohiltea et al. Maedica (Bucur). 2021 Dec.

Abstract

Double aortic arch represents a congenital vascular malformation that is characterized by the development of a complete vascular ring around the esophagus and trachea due to an anomaly in the development of branchial arteries. We present the case of a 31-year-old gravida that was referred for fetal ultrasound anomalies screening at 22 weeks and six days of gestation. Routine ultrasound scanning of the fetus revealed a structural aortic arch anomaly consistent with a double aortic arch, with no other cardiac and diextracardiac congenital structural malformations. Knowledge of embryology and imaging spectrum of aortic arch anomalies that are able to form vascular rings around the trachea and esophagus are essential for an accurate antenatal diagnosis and therefore, for a correct clinical management.

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Figures

FIGURE 1.
FIGURE 1.
Double aortic arch case. Normal great vessel emergences, 2D standard images, sustain the bifurcation of the aortic arch anteriorly to the trachea, from the ascending aorta. The descending aorta (orange arrow); left ventricular outflow tract (red); right ventricular outflow tract (white)
FIGURE 2.
FIGURE 2.
Double aortic arch case. Color Doppler vascular ring in transverse view of the fetal thorax at the level of the three-vessel and trachea view. The arrow indicates the trachea
FIGURE 3.
FIGURE 3.
Double aortic arch case. Color Doppler longitudinal section of double aortic arch; the right arch is larger (yellow arrow) than the left hypoplastic one (white arrow) and is located more cephalic
FIGURE 4.
FIGURE 4.
Double aortic arch case. Color Doppler in transverse plan of the fetal thorax at the level of ductus arteriosus. The bifurcation of the aorta into a right and left aortic arch (red arrow); superior vena cava (yellow arrow); trachea (white arrow); pulmonary artery (orange arrow)
FIGURE 5.
FIGURE 5.
Normal karyotype of double aortic arch case
FIGURE 6.
FIGURE 6.
Right aortic arch associating an aberrant left subclavian artery and a left-sided ductus arteriosus case. Normal two-dimensional four-chamber view
FIGURE 7.
FIGURE 7.
Right aortic arch associating an aberrant left subclavian artery and a left-sided ductus arteriosus case. The ascending aorta takes an opposite direction from the usual normal one (red arrow)
FIGURE 8.
FIGURE 8.
Right aortic arch associating an aberrant left subclavian artery and a left-sided ductus arteriosus case. Color Doppler vascular ring in transverse view of the fetal thorax at the level of the “V”- sign view. The image is completely different from the one presented in the case of double aortic arch. Aorta (red arrow) and pulmonary artery (orange arrow)
FIGURE 9.
FIGURE 9.
Right aortic arch associating an aberrant left subclavian artery and a left-sided ductus arteriosus case. HD flow vascular ring. Ductus arteriosus arises at the origin of the aberrant subclavian artery and takes an anterior course for connecting to the pulmonary artery. Superior vena cava (yellow arrow); trachea (white arrow)
See this image and copyright information in PMC

References

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