Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. May 28, 2012; 4(5): 231-235
Published online May 28, 2012. doi: 10.4329/wjr.v4.i5.231
Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery
Francesco Paparo, Lorenzo Bacigalupo, Enrico Melani, Gian Andrea Rollandi, Giovanni De Caro
Francesco Paparo, Lorenzo Bacigalupo, Enrico Melani, Gian Andrea Rollandi, School of Radiology, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
Francesco Paparo, Lorenzo Bacigalupo, Enrico Melani, Gian Andrea Rollandi, Giovanni De Caro, E.O. Ospedali Galliera, Operative Unit of Radiology, Mura delle Cappuccine 14, 16128 Genoa, Italy
Author contributions: All authors contribute equallly to this manuscript.
Correspondence to: Francesco Paparo, MD, School of Radiology, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy. francesco.paparo.ge@fastwebnet.it
Telephone: +39-349-3538670 Fax: +39-349-6161570
Received: August 13, 2011
Revised: December 12, 2011
Accepted: December 19, 2011
Published online: May 28, 2012
Abstract

Right-sided aortic arch with aberrant left subclavian artery (RAA/ALSC) is the second most common mediastinal complete vascular ring. Adult presentation of dysphagia lusoria due to a RAA/ALSC is uncommon with fewer than 25 cases reported in the world literature. The left lateral portion of this vascular ring is not a vessel, but an atretic ductus arteriosus, the ligamentum arteriosum, which has been identified in different cases as the major cause of tracheo-esophageal impingement. Surgical division of the ligamentum arteriosum allows the vessels to assume a less constricting pattern decreasing dysphagic symptoms. Clear visualization of the ligamentum arteriosum by diagnostic imaging has not been obtained in previously reported cases. We demonstrated, using magnetic resonance imaging, the location and the complete course of a left-sided ligamentum arteriosum in a patient with adult-onset dysphagia due to a RAA/ALSC with a small Kommerell’s diverticulum, providing, during the same session, a complete assessment of both mediastinal vascular abnormalities and esophageal impingement sites.

Keywords: Dysphagia Lusoria; Ligamentum arteriosum; Right aortic arch