From the Department of Cardiovascular Radiology, Broussais Hospital,
Paris, France.
Correspondence to Dr Thierry Carreres, Service de Radiologie Cardiovasculaire, Hôpital Broussais, 96 rue Didot, 75014 Paris, France. E-mail thierry carreres@brs.ap-hop-paris.fr
A 60-year-old man
without cardiac history underwent angiography to assess the severity of
bilateral carotid artery stenosis. A right anterior oblique
view of the aortic arch revealed an unusual presentation
with a left innominate artery (Figure 1
Footnotes
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
© 1998 American Heart Association, Inc.
Images in Cardiovascular Medicine
Unusual Aortography
).
The left oblique view showed the left innominate artery emerging from
the aorta before the right carotid and right subclavian arteries
(Figure 2). The front view confirmed the
diagnosis of right aortic arch with mirror-image branching and
right-sided descending aorta (Figure 3).
There was no patent ductus arteriosus. Three-dimensional computer
reconstruction of electron-beam CT images confirmed the diagnosis and
the lack of vascular ring (Figure 4),
explaining why the patient never had stridor or dysphagia. This anomaly
is usually associated with a congenital cyanotic heart defect, but in
this patient, clinical and echocardiographic
examinations were normal.
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Figure 1.
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Figure 2.
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Figure 3.
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Figure 4.