CTICasesRight Aortic Arch with Aberrant Left Subclavian Artery and Kommerell's Diverticulum
Imaging findings
CT angiogram demonstrates a right-sided aortic arch with an aberrant left subclavian artery arising from a large, bulbous posterior outpouching, representing a Kommerell's diverticulum. The vascular ring is completed by a left-sided ligamentum arteriosum anchored to the left pulmonary artery, which causes compression of the trachea and esophagus.
Key takeaways
A right aortic arch with an aberrant left subclavian artery is a classic congenital arch variant that forms a vascular ring when a left ligamentum arteriosum is present. The Kommerell's diverticulum represents the remnant of the primitive left dorsal aorta. Surgical management typically involves division of the ligamentum and may include resection of the diverticulum to alleviate mass effect and prevent future aneurysmal degeneration.
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