CTICasesDouble Aortic Arch with Left Arch Dominance
Imaging findings
Contrast-enhanced chest CT and 3D reformations reveal a double aortic arch vascular ring, characterized by a dominant left arch and a very small, hypoplastic right arch encircling the trachea and esophagus.
Key takeaways
Double aortic arch is a congenital vascular anomaly where both the left and right fourth embryonic arches persist. While a right-dominant arch is far more common, left-arch dominance can occur as a rare variant. Late surgical repair in asymptomatic elderly patients carries a high risk of complications, such as chylothorax.
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