CTICasesRight Aortic Arch with Mirror-Image Branching and Right-Sided Ligamentum Arteriosum
Imaging findings
Chest CT shows a right-sided aortic arch with mirror-image branching (three-vessel arch containing a left brachiocephalic, right common carotid, and right subclavian artery) in a patient with normal visceral situs and a right-sided superior vena cava. Sagittal and coronal reformats demonstrate a distinct ductus/ligamentum bump originating from the inner aspect of the right arch and extending directly to the right pulmonary artery, confirming a right-sided ligamentum arteriosum.
Key takeaways
Although right aortic arches are usually associated with a left-sided ligamentum arteriosum, some cases may exhibit a right-sided ligamentum. A right aortic arch with mirror-image branching is typically associated with congenital heart disease, but can occasionally be seen in asymptomatic adults without intracardiac anomalies.
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