Aortic Arch Anomalies: Simplified Classification

Between the years 1965 and 1970, ten patients were operated on for congenital anomalies of the aortic arch which caused symptoms of tracheoesophageal compression. The classic Edwards' diagram was modified for a more simple mterpretation of these anomalies. Accordingly, all our patients were found to belong to four distinct variations: 1) double aortic arch, which was divided in twosubgroups, a) with functioning double aortic arch, b) with partial involution of one of the arches; 2) right aortic arch, mirror image branching of the arch vessels and retroesophageal aortic diverticulum with left arterial duct or Ugament connected to the diverticulum; 3) right aortic arch with left aberrant retroesophageal subclavian artery; 4) Left aortic arch with right aberrant retroesophageal subclavian artery. All palients were operated on through a left thoracotomy; the technique used varied according to the anomaly found. There was no surgical mortality. One patient's death four months following operation was caused by a technical error which allowed obstruction of tracheal tube during emergency treatment for tracheomalacia. The remaining nine patients have been asymptomatic in an observation period of six months to five years.