CTICasesDouble Aortic Arch with Atretic Left Segment and Secundum ASD
Imaging findings
Chest radiography shows deviation and mass effect on the trachea with large, prominent central and segmental pulmonary arteries. CT angiography reveals a double aortic arch with an atretic left-sided arch segment, crossing posterior to the trachea and descending on the left side to form a vascular ring. Additionally, there is severe enlargement of the right ventricle, right atrium, and pulmonary arteries, with a widely patent secundum atrial septal defect (ASD) and associated tracheomalacia of the left main bronchus.
Key takeaways
Double aortic arch with an atretic segment is a type of vascular ring that can cause symptomatic compression of the airway and esophagus, leading to tracheobronchomalacia and recurrent respiratory symptoms. Congenital vascular rings can coexist with other congenital heart defects, such as a secundum atrial septal defect (ASD), which should be suspected when there is disproportionate enlargement of the right-sided cardiac chambers and pulmonary arteries.
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