IPCCC: 09.31.29 or 09.31.12, 09.31.07
 

AEPC Derived Term:    

Vascular ring: right aortic arch & left arterial ligament with aberrant retroesophageal left subclavian artery (09.31.29) or

Vascular ring: right aortic arch & left arterial duct from aberrant retroesophageal left subclavian artery if the duct is patent (09.31.12)

EACTS-STS Derived Term:    

Vascular ring, Right aortic arch + left ligamentum, Retroesophageal left subclavian artery (aberrant left subclavian artery) (09.31.12) and

Vascular ring, Right aortic arch + left ligamentum-modifier, Ligamentum is patent (if duct is patent) (09.31.07)

Definition:  pending

Common Synonyms:  Kommerell diveticulum = retroesophageal aortic diverticulum

Modality: Anatomic specimen

Orientation: Cephalo-caudal

Description: This cephalic view of the great vessels demonstrates a U-shaped vascular loop composed of a right aortic arch (RAA) with distal origin of the left subclavian artery (LSA) and a left arterial ligament along with the pulmonary trunk (PT). This U-shaped vascular loop extends around the trachea (T) and esophagus (E), the two arms of the U-shaped loop attached to the heart, completing the vascular ring. The arrangement demonstrates what is seen in postnatal circulation with a closed arterial duct and the proximal portion of the distal origin of the left subclavian artery representing the distal remnant of the left aortic arch. This remnant is commonly referred to as the diverticulum of Kommerell. The brachiocephalic vessels branch from the right aortic arch in the following fashion: left common carotid (LCC), right common carotid (RCC), right vertebral (RVA) and right subclavian (RSA). (Note that the right aortic arch was transected and reapproximated with the descending aorta. The trachea and esophagus were removed from the cardiac block, replaced by a piece of chalk to demonstrate the vascular ring around those structures.) (A-aorta, DA-descending aorta, LPA-left pulmonary artery, RPA-right pulmonary artery)

Contributor: Diane Spicer, BS

Institution: The Congenital Heart Institute of Florida (CHIF)

Image Label:  A093129-67a

Image Source: Idriss Archive, Children’s Memorial Hospital, Chicago, IL

Image Certification: pending

AWG Rating:  pending

Modality: Anatomic specimen

Orientation: Cephalo-caudal

Description: This vascular ring represents the arrangement seen in postnatal circulation following closure of the arterial duct. The proximal portion of the aberrant left subclavian artery represents the distal remnant of the left aortic arch and usually persists as the diverticulum of Kommerell (yellow arrow). This diverticulum is partially hidden by the esophagus. (LCC-left common carotid, RCC-right common carotid, RSA-right subclavian artery, LSA-left subclavian artery, SCV-superior caval vein, A-aorta, PT-pulmonary trunk, T-trachea, E-esophagus)

Contributor: Diane Spicer, BS

Institution: The Congenital Heart Institute of Florida (CHIF)

Image Label:  A093129-67b

Image Certification: pending

AWG Rating:  pending

Modality: Cardiac CT image (contrast-enhanced)

Orientation: Axial slices

Description: This set of axial CT images show a vascular ring formed by a right-sided aortic arch and a left arterial ligament. There is a broad diverticulum of Kommerell and aberrant left subclavian artery.

Contributor: Marina Hughes, DPhil, MRCP, FRACP

Institution: Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children NHS Trust, London, UK

Image Label:  CT093129-67c

Source of Image: Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children NHS Trust, London, UK

Image Certification: pending

AWG Rating: pending

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