Vatish Jamie, McCarthy Robert, Perriss Richard
Department of Vascular Surgery, South Devon Health Care Trust, Torquay, UK
Department of Vascular Surgery, South Devon Health Care Trust, Torquay, UK.
J Surg Case Rep. 2013 Oct 4;2013(10):rjt081. doi: 10.1093/jscr/rjt081.
A 64-year-old woman presented to the Vascular Outpatient department concerned about a pulsatile swelling in her right supraclavicular fossa. She had no other symptoms. A computed tomography angiogram demonstrated a double aortic arch (DAA) with the innominate artery arising from the right arch and left common carotid and subclavian arteries arising from the left arch. There were no aneurysms. A DAA accounts for 1% of congenital cardiac disease. It is the commonest form of a complete vascular ring, caused by a failure of the embryological, right, fourth pharyngeal arch to regress. Patients typically present in childhood with symptoms arising from tracheal and oesophageal compression, which frequently require surgical intervention. There is a paucity of evidence on how to manage this disease in adulthood, with only a handful of reported cases. Our patient was treated conservatively with advice about potential complications.
一名64岁女性因右锁骨上窝出现搏动性肿块就诊于血管门诊。她无其他症状。计算机断层血管造影显示双主动脉弓（DAA），无名动脉发自右弓，左颈总动脉和左锁骨下动脉发自左弓。无动脉瘤形成。双主动脉弓占先天性心脏病的1%。它是完全性血管环最常见的形式，由胚胎期右侧第四咽弓退化失败引起。患者通常在儿童期出现因气管和食管受压导致的症状，常需手术干预。关于如何治疗成年期这种疾病的证据很少，仅有少数病例报道。我们的患者接受了保守治疗，并被告知可能的并发症。
