Right Aortic Arch with an Aberrant Retroesophageal Innominate Artery: Angiographic Diagnosis

A retroesophageal innominate artery is a rare congenital anomaly theoretically occurring if there is a break in either aortic arch proximal to the origin of the common carotid artery. The resulting vessel is the last off the arch and gives origin to a subclavian and common carotid artery (Fig. 1). In reality a persistent dorsal aortic root (5), this vessel may then be considered an innominate artery. The purpose of this paper is to report an angiographically documented, right aortic arch with retroesophageal left innominate artery and to indicate an error that has been made in the diagnosis of this anomaly. S. G., a 19-year-old white male, was referred for evaluation because of a heart murmur and dyspnea on strenuous exertion. His past history was interesting in that he had been hospitalized for four and a half months during the first year of his life with a diagnosis of “mucoviscidosis and aspiration pneumonia.” There had been difficulty with feedings associated with intermittent periods of cough, cyanos...