Aberrant right subclavian artery in children examined at the National Institute of Cardiology Ignacio Chavez (1992-2012)

• Published in: Archivos de cardiología de México Vol. 84; no. 3; pp. 155 - 161
• Main Authors: Mijangos-Vázquez, Roberto, Patiño-Bahena, Emilia, Martínez-García, Alfonso, Herrera, Juan, Calderón-Colmenero, Juan, Buendía-Hernández, Alfonso, Soto-López, María Elena
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01-07-2014
• Subjects: Academies and Institutes; Aneurysm - diagnosis; Aneurysm - surgery; Cardiology; Cardiovascular Abnormalities - diagnosis; Cardiovascular Abnormalities - surgery; Child; Child, Preschool; Deglutition Disorders - diagnosis; Deglutition Disorders - surgery; Female; Humans; Infant; Male; Retrospective Studies; Subclavian Artery - abnormalities; Subclavian Artery - surgery; Arco aórtico; Aberrant right subclavian artery; Aortic arch; Vascular lesions; Mexico; México; Arteria subclavia derecha aberrante; Malformaciones vasculares
• ISSN: 1405-9940
• DOI: 10.1016/j.acmx.2013.10.010

Congenital vascular malformations of the major arteries in the chest have been classified into 5 groups: 1) double aortic arch; 2) right aortic arch with left ligament or persistent ductus arteriosus; 3) aberrant subclavian artery; 4) aberrant left pulmonary artery, and 5) anomalous innominate artery. We reviewed the patients with aberrant right subclavian artery and their treatment.
We studied retrospectively the records of 29 patients with aberrant right subclavian artery in childhood, from January 1992 to December 2012, analyzing the following variables: age at onset, clinical manifestations, associated cardiovascular defects, diagnosis and surgical approach method.
We found that most patients have an asymptomatic course, only 31% of them course with symptoms during the first year of life, with an incidental diagnosis of 35% during catheterization or other imaging studies. Patent ductus arteriosus was the most frequently associated congenital malformation, with 13%. Down's syndrome was found in 21%. The most common treatment was surgical section of the aberrant subclavian artery to release the esophagus.
This vascular abnormality must be suspected in those patients with dysphagia, dyspnea, chest pain during feeding or breathing difficulties. A significant number of patients are not diagnosed in time, some reach adulthood without a diagnosis. This malformation is often found in imaging studies when evaluating the aorta or in a gastroesophageal reflux study, in which the barium bolus reveals the extrinsic compression of the esophagus.