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Classification scheme for aortic arch anomalies leading to a vascular ring. All types can potentially cause esophageal compression. Esophageal compression is less likely in Type 2 and 6. Legend: (0) normal anatomy of the aortic arch; (1) Type 1, persistent right aortic arch with left ligamentum arteriosum; (2) Type 2, persistent right aortic arch with persistent left subclavian artery; (3) Type 3, persistent right aortic arch with left ligamentum arteriosum and left subclavian artery; (4) Type 4, double aortic arch; (5) Type 5, normal left aortic arch with right ligamentum arteriosum; (6) Type 6 normal left aortic arch with persistent right subclavian artery; (7) Type 7, normal left aortic arch with persistent right ligamentum arteriosum and right subclavian artery; (8) Type 8, right aortic arch with left subclavian branching from the PDA; (9) Type 9, right sided aortic arch with left-sided brachiocephalic trunk including both carotid arteries and the left subclavian artery referred to as "mirror" image. The blue region represents the pulmonary arteries and the black region the ligamentum arteriosum. Type 1 to 7 previously described by Ellison G. Vascular Ring Anomalies in the dog and cat. Compendium on Continuing Education for the Practicing Veterinarian -North American Edition-. 1980;2:693-705
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Background
Congenital anomalies of the aortic arch are important as they may be associated with vascular ring anomalies. The most common vascular ring anomaly in dogs is a persistent right aortic arch. However, published data of the distribution of the different types of vascular ring anomalies and other aortic arch anomalies are lacking. The objec...
Contexts in source publication
Context 1
... left ligamentum arteriosum and left subclavian artery; Type 4, double aortic arch; Type 5, normal left aortic arch with persistent right ligamentum arteriosum; Type 6, normal left aortic arch with persistent right subclavian artery; Type 7, normal left aortic arch with persistent right ligamentum arteriosum and right subclavian artery [9,10] (Fig. 1). Because of the increased availability of computed tomography (CT), more thoracic CT studies are available, and aortic arch anomalies can be detected even in cases without clinical signs of vascular ring anomaly. To the authors knowledge, there is no data describing the frequency of aortic arch anomalies that could be detected during ...
Context 2
... and is the second most common form of a right-sided aortic arch [1]. The findings of the current study show that a left-sided brachiocephalic trunk also occurs in dogs, with a prevalence of 14.3% of dogs with right aortic arch in the own study population. Therefore, complementing the current classification scheme by the new type is proposed (Fig. ...
Context 3
... is defined by an isolated left subclavian artery, is caused by regression of the left arch at two segments cranially and caudally to the left subclavian artery [1]. Like the previously reported type, this variant has not yet been characterized and should be included in the new modulated classification scheme, which is proposed by the authors (Fig. 1). Regarding surgical treatment, in both cases, ligation and dissection of the left subclavian artery were performed. In human medicine occlusion or stenosis of the proximal subclavian artery results in reversal blood flow through the vertebral artery. Common clinical signs are vertigo, syncope, and intermittent claudication of the ...
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This paper aims to discuss the value of ultrasound to diagnose right aortic arch with right arterial duct. A retrospective analysis of fetal echocardiography characteristics of 10 fetuses who were diagnosed as right aortic arch with right arterial duct from December 2016 to March 2021 is made, and focus is put on the relationship between the aortic...
Citations
... An aberrant right subclavian artery (ARSA), a vascular ring anomaly leading to esophageal constriction and dilation, is a rare developmental abnormality in dogs [13][14][15]. The right subclavian artery normally arises from the brachiocephalic trunk and supplies blood to the right thoracic limb, thorax, and neck [16]. ...
... The right subclavian artery normally arises from the brachiocephalic trunk and supplies blood to the right thoracic limb, thorax, and neck [16]. In cases of ARSAs, this artery arises directly from the aortic arch caudal to the left subclavian artery and then courses from the same location as the left subclavian artery toward the right thoracic limb, passing the esophagus along its dorsal aspect [14,15]. Generally, an ARSA is characterized by the lack of early-onset clinical signs and mild esophageal dilation; it may present as an incidental finding without clinical relevance [15,17]. ...
... In cases of ARSAs, this artery arises directly from the aortic arch caudal to the left subclavian artery and then courses from the same location as the left subclavian artery toward the right thoracic limb, passing the esophagus along its dorsal aspect [14,15]. Generally, an ARSA is characterized by the lack of early-onset clinical signs and mild esophageal dilation; it may present as an incidental finding without clinical relevance [15,17]. However, similar to other vascular ring anomalies, dogs with ARSAs often develop clinical signs, such as regurgitation [16,18,19]. ...
A 13-year-old spayed female cocker spaniel was presented with a 2-month history of swelling in several digits and intermittent hindlimb lameness. Radiographs revealed marked soft-tissue swelling and periosteal new bone formation without cortical bone destruction, characteristic of hypertrophic osteopathy (HO), in the distal parts of all extremities except for the right forelimb. However, no notable findings were detected in thoracic radiographs. An ultrasonography indicated cranial bladder wall thickening, which resolved following antibiotic therapy. Computed tomographic angiography identified a potential underlying cause as an aberrant right subclavian artery (ARSA) originating from the aortic arch, compressing the esophagus and causing mild esophageal cranial dilation to the aberrant vessel. No other intrathoracic or neoplastic lesions were observed. Gastrointestinal symptoms, such as regurgitation, were absent. Although an ARSA was likely the cause of HO, surgical correction was declined by the owner. To the best of our knowledge, this is the first reported case of HO concurrent with ARSA in dogs.
... Knowledge of the normal pattern is essential for identifying anomalies in aortic arch branching during radiological diagnosis, such as in domestic carnivorans (Kim et al., 2017;Schorn et al., 2021;Sebastian-Marcos et al., 2019). In addition, it is necessary in surgical approaches to the thoracic cavity at the level of the cranial mediastinum (Wyatt & Rutllant, 2022). ...
... (3/275) (Vitums, 1962), 0.8% (7/802) (Sebastian-Marcos et al., 2019) and 1.6% (3/192) (Schorn et al., 2021). The anomalous origin of the right subclavian artery occurs when the right dorsal aorta disappears between the fourth aortic arch and the seventh dorsal intersegmental artery, while the caudal part remains (Sinowatz, 2009). ...
... The anomalous origin of the right subclavian artery occurs when the right dorsal aorta disappears between the fourth aortic arch and the seventh dorsal intersegmental artery, while the caudal part remains (Sinowatz, 2009). This anomalous origin of the right subclavian artery rarely causes clinical signs (Schorn et al., 2021;Sebastian-Marcos et al., 2019;Sinowatz, 2009;Vitums, 1962), which agrees with that found in the L. longicaudis specimen, which did not have signs before death. There are some reports where it generated clinical signs in C. lupus familiaris, such as regurgitation due to oesophageal compression (Miller et al., 2015;Tavares et al., 2020) and hypotension of the right thoracic limb (Kim et al., 2017). ...
The Neotropical otter (Lontra longicaudis) is a mustelid distributed geographically from Mexico to Argentina. Anomalous origins of the aortic arch branches are rarely reported in wild carnivorans. Therefore, this study aimed to report the anomalous branching of the aortic arch in one formaldehyde-fixed specimen of L. longicaudis. The aortic arch provided three branches: the bicarotid trunk and the left and right subclavian arteries. The latter passed dorsally to the esophagus toward the right side without a mark of compression at the esophagus. This is the first report of an anomalous origin of the right subclavian artery in L. longicaudis.
... Vascular ring anomalies are congenital malformations of the aortic vasculature and its branches resulting in abnormal development of the embryonic aortic arches, leading to esophageal compression and dilation, and in addition, implying a significant potential risk for airway compression (Buchanan, 2004;Schorn et al., 2021). Together with patent ductus arteriosus (PDA), the persistent right aortic arch (PRAA) is among the central vascular anomalies in dogs and cats (Henjes et al., 2011;Hutton et al., 2015), although it is rarer in cats than in dogs, with literature limited to some reported clinical cases (Bascuñán et al., 2020;Plesman et al., 2011;Shannon et al., 2015). ...
... However, accurately delineating the vessel wall and providing comprehensive images in a three-dimensional perspective allows computed tomography (CT) to confirm the diagnostic suspicion (Schorn et al., 2021). CT imaging is still instrumental in the simultaneous assessment of airway obstructions and may have implications for management and prognosis (Henjes et al., 2011). ...
... Vascular rings encompass branching aortic arch abnormalities that can result in varying degrees of esophageal and airway compression (Henjes et al., 2011). The PRAA is one of the dogs' most common congenital vascular defects, where Labrador Retrievers, German Shepherds, and Irish Setters appear to be most at risk (Schorn et al., 2021). Although well-documented in dogs, vascular anomalies are considered uncommon in cats. ...
Aortic arch anomalies can give rise to vascular rings, such as persistent right aortic arch (PRAA), a rare vascular anomaly in cats with significant health implications. Here, we report late surgical correction in a case of PRAA, an almost 12-month-old cat with the clinical syndrome of dysphagia and postprandial regurgitation. The patient was presented to the veterinary hospital at FMVZ-USP with a history of chronic regurgitation since puppyhood after weaning, with a significant worsening of the clinical condition 10 days ago. Computed tomography had a potential role in diagnosing and detecting complications of PRAA, allowing surgical planning. Approach via left thoracotomy and section of the arteriosus ligament resulted in the successful resolution of extrinsic esophageal compression due to PRAA with the restoration of normal swallowing of a dry diet by the cat and absence of esophageal sequelae on radiographic assessment in a six-month clinical follow-up.
... The vertebral artery branches off from the subclavian artery [21]. The most similar pattern of vessels was described in the cat [23], dog [24], red squirrel [25], and ground squirrel [26]. In these species, the bicarotic trunk is absent. ...
The red kangaroo (Osphranter rufus) is a member of Macropidideae superfamily. It is one of the four kangaroo species living nowadays, and it is the biggest one. It is native to Australia, where it is an abundant species living across the whole continent in stable populations. Outside its natural habit, the red kangaroo is a common species found in zoos and as patients in wildlife rehabilitation centers. Reports on kangaroo anatomy are scarce. Describing detailed anatomy is a base for establishing diagnostic and treatment protocols for different species of animals. Cardiovascular diseases and pathological changes suggestive of hypertension have been previously described in kangaroos. This creates a necessity for detailed studies on species’ vascular anatomy. New reports in the field of detailed vascular anatomy can bring considerable information that complements numerous studies on the evolution or biology of individual species. In this article, we describe the arterial vascularization of the brain and nearby regions of the cranial cavity using various anatomical techniques. The vascularization of the brain is discussed and compared with different mammalian species.
... Surgical treatment, via transection of the LA, is indicated in these patients. It has been estimated that PDA occurs concurrently in only 10%-14% of animals with PRAA (Buchanan, 2004;Schorn et al., 2021;vanGrundy, 1989). ...
... Vascular comorbidities with PRAA are not uncommon with reports of up to 44% of dogs with PRAA having at least one coexisting compressive arterial anomaly (Buchanan, 2004). PDA is a far less common comorbidity in dogs with PRAA, being identified concurrently in only 10%-14% of dogs (Buchanan, 2004;Schorn et al., 2021;vanGrundy, 1989). Although many reports of combined PRAA and PDA in both neonatal dogs and humans have identified the usual high-grade continuous murmur of a PDA, the dog in this report lacked an audible heart murmur (Christiansen et al., 2007;Dundie et al., 2017;Holt et al., 2000;Reed & Bonasch, 1964;Salamat & Lyon, 2009;Saunders et al., 2013). ...
A 4‐month‐old intact female German shepherd dog was presented with a history of postprandial regurgitation, a palpably distended cervical oesophagus after eating, and poor weight gain despite a ravenous appetite. Computed tomography angiography, esophagoscopy and echocardiography identified a persistent right aortic arch with a concurrent patent ductus arteriosus (PDA) causing extraluminal oesophageal compression leading to marked segmental megaoesophagus. A heart murmur was not detectable. A left lateral thoracotomy was performed to ligate and transect the PDA without complication. The dog was discharged with mild aspiration pneumonia which resolved with antimicrobial therapy. Twelve months post‐surgery the owners reported no regurgitation.
... Pure-breed dogs are most commonly affected, with the German Shepherd Dog being overrepresented. 1 In embryonic development, the aorta normally develops from the left fourth aortic arch, and the right fourth aortic arch contributes to the right subclavian artery. The ductus arteriosus develop from the sixth aortic arches. ...
... The ligamentum arteriosum remains. 1 As a result, the aorta, main pulmonary artery, and ligamentum arteriosum lie to the left of the trachea and esophagus. In dogs with PRAA, the aorta develops on the right and the ligamentum arteriosum spans from the aorta, across the dorsal aspect of the esophagus at the level of the heart base, to the left pulmonary artery, compressing the esophagus cranial to the heart base. ...
... 5 Therefore, in some cases, CT angiography can be performed for surgical planning purposes, as it has been proven to provide valuable information about the exact configuration of the PRAA and concurrent ring vascular anomalies. 1,3 ...
This paper reports the clinical findings and surgical treatment of feline right patent ductus arteriosus (RPDA) with a left aortic arch. A two-month-old female Maine Coon was referred for an investigation of regurgitation after weaning. RPDA with a left aortic arch was diagnosed based on the echocardiographic and computed tomography (CT) findings. A right-fourth intercostal thoracotomy was found to be an appropriate approach to the duct. Preoperative diagnosis is crucial and diagnostic imaging, including radiography, echocardiography, and cardiac CT examination, is essential for determining if the aortic arch is right or left.
Double aortic arch (DAA) is a rare, congenital anomaly in small animals, resulting in a complete vascular ring encircling the esophagus and trachea, and subsequent compression of these organs. Few studies have reported utilizing CT angiography (CTA) for diagnosing DAA in dogs; thus, the imaging features are currently lacking in the literature. The objectives of this retrospective, multicenter, descriptive case series were to report the clinical and CTA characteristics of DAA in surgically treated cases. Medical records and CTA images were reviewed. Six juvenile dogs met the inclusion criteria (median age: 4.2 months; range: 2-5 months). The most common clinical signs included chronic regurgitation (100%), decreased body condition (67%), and coughing (50%). Common CTA features of DAA included a dominant left aortic arch (median diameter: 8.1 mm) and minor right aortic arch (median diameter: 4.3 mm; 83%), an aberrant right subclavian artery arising directly from the right aortic arch (83%), segmental esophageal constriction (100%), and variable degrees of dilation cranial to the heart base, and marked tracheal luminal compression (median percent change: -55%; 100%) and leftward curvature of the trachea at the level of the bifurcation of the aortic arches (100%). All dogs underwent successful surgical correction with only minor postoperative complications. Due to the similarity of clinical and imaging characteristics described to that of other forms of vascular ring anomalies (VRA), CTA is vital for the specific diagnosis of DAA in dogs.
