Consecutive examinations were evaluated using the software available at the Radiology Department (Advantage Workstation 4.4 GE Waukesha, Wisconsin, US), allowing cases with right-sided aortic arch to be identified. Table Table1 1 presents a summary of the examinations of the patients. Magnetic resonance angiography was performed using time-of-flight technique and after administering a contrast agent (Magnetom Avanto 1.5 T, Siemens, Erlangen, Germany). The patients had undergone contrast-enhanced computed tomography angiography, slice thickness 0.625 mm-1.5mm (Light-Speed 64 VCT, GE, Waukesha, Wisconsin, US) and/or magnetic resonance angiography. This database comprised 11,690 CT examinations of the chest, 19,623 CT examination of brain-supplying vessels, and 1863 MRI examinations of the heart and aortic arch or brain-supplying arteries. The database of the Radiology Department was retrospectively analyzed between January 2008 and May 2016 using the keyword “right aortic arch”. The aim of the present study was to review previous multidetector computed tomography (MDCT) angiography and magnetic resonance imaging findings of the right-sided aortic arch, which were additionally evaluated in ultrasonography, to determine the occurrence of concomitant vascular insufficiency of the aortic arch arteries in patients with RAA. It may be associated with congenital heart disease, especially tetralogy of Fallot. This rare anomaly may cause congenital subclavian steal syndrome and vertebrobasilar insufficiency. In RAA with isolation of the LSA, the LSA does not have a connection with the aorta, but is connected to the pulmonary artery by a left ductus arteriosus. RAA with mirror image is usually associated with a form of cyanotic congenital heart disease, especially tetralogy of Fallot and truncus arteriosus. This anomaly is rarely associated with other cardiovascular abnormalities. Respiratory symptoms due to tracheal compression may be present in pediatric patients. Symptoms of esophageal compression may develop in older individuals with ectasia, tortuosity or aneurysm of the ALSA. This anomaly rarely produces symptoms and is usually an incidental radiological finding. In RAA with ALSA, ALSA may arise from a remnant of the left dorsal aortic root (Kommerell’s diverticulum). The Edwards classification describes three types: RAA (right aortic arch) with ALSA (aberrant left subclavian artery), RAA with mirror image branching, and RAA with isolation of the left subclavian artery (LSA). Several classifications of these anomalies have been proposed based on the arrangement of the arch vessels, relationships with the esophagus, or the presence of congenital heart anomalies. It is present in 0.05% to 0.1% of radiology series and in 0.04%-0.1% of autopsy series. A right-sided aortic arch is a rare congenital defect of the aorta.
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