The Relationship between Chest Pain and Right Aortic Arch with Left Aberrant Subclavian Artery

Aberrant subclavian artery is a rare anomaly among all anomalies related to aortic arch. In some cases kind of aneurysm named Kommerell diverticulum, originated from right subclavian artery and left aortic arch and the opposite, left subclavian artery association with right aortic arch [۱]. Right Aortic Arch(RAA) is a rare congenital anomaly with ۰.۵ to ۱% of normal population. Almost half of the Cases associated with left aberrant subclavian artery and in some, aneurysmal changes in the origin of the artery is inevitable [۲]. RAA is categorized in three groups : ۱.RAA with left aberrant Subclavian artery۲.RAA in mirror type.۲.RAA with isolated LSA, which RAA with ILSA is a most rare by ۰.۸ % prevalence [۳]. Left aberrant subclavian artery (LASA) is an anatomical variant of right aortic arch which is actually dispart from the RAA as a last branch and usually pass behind esophagus to the left upper limb. However, RASA associated with LAA is more common (۰.۵_۲% of population) the LASA originated from RAA(۰.۰۵_۰.۱) [۴]. Kommerells diverticulum or KD, is defined as a aneurysmal form of ASA or descending aorta in proximal part [۵] .KD is a rare condition usually accompany RASA more than LASA [۶, ۷]. Up to now, few cases has reported. Burckhard F Kommerell was the first one who introduced kommerell in ۱۹۳۶ [۸]. Anomalies of aortic arch not necessary influence health condition in childhood and some become symptomatic in adolescence [۹]. These aneurysms could be strong threatening for some circumstances like dissection, rupture, emboli to distal parts, compression to adjacent or organs [۱].

Keywords:

chest pain , right Aortic arch , aberrant subclavian artery