Surgical Treatment of an Isolated Origin of the Right Subclavian Artery From the Pulmonary Artery

Surgical Treatment of an Isolated Origin of the Right Subclavian Artery From the Pulmonary Artery Christian Schreiber, MD, PhD, Julie Cleuziou, MD, Andreas Eicken, MD, PhD, and Rüdiger Lange, MD, PhD Clinic of Cardiovascular Surgery and Department of Paediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University, Munich, Germany

Fig 1.

A

heart murmur and suspected persistent ductus arteriosus led to further investigation in an otherwise healthy 4-year-old child. Echocardiography revealed an anomalous vessel arising near the pulmonary trunk (Fig 1, arrow). An angiogram confirmed the rare anomaly (Fig 2); however, any additional structural anomalies of the heart and adjacent structures were ruled out. After median sternotomy, the aberrant artery was mobilized and was then anastomosed to the lateral aspect of the aorta. At discharge, there was no relevant arm pressure discrepancy.

Address correspondence to Dr Schreiber, German Heart Center Munich, Clinic of Cardiovascular Surgery at the Technical University, Germany, Lazarettstrasse 36, Munich, 80636, Germany; e-mail: schreiber@dhm. mhn.de.

© 2009 by The Society of Thoracic Surgeons Published by Elsevier Inc

Fig 2.

The finding of an aberrant right subclavian artery should prompt further assessment for aortic arch or intracardiac anomalies [1, 2].

References 1. Ramaswamy P, Lytrivi ID, Thanjan MT, et al. Frequency of aberrant subclavian artery, arch laterality, and associated intracardiac anomalies detected by echocardiography. Am J Cardiol 2008;101:677– 82. 2. Freed K, Low VH. The aberrant subclavian artery. AJR Am J Roentgenol 1997;168:481– 4.

Ann Thorac Surg 2009;87:e8 • 0003-4975/09/$36.00 doi:10.1016/j.athoracsur.2008.09.064