Dysphagia lusoria in combination with multiple congenital anomalies of the aortic arch.

Fig. 1. CTaxial image (a) evidences the anomalous origin of both carotid arteries from a unique trunk and demonstrates the presence of an aberrant right subclavian artery which passes ahead the thoracic spine inducing extrinsic compression of the esophagus. The origin of the bi-carotid trunk, which arises directly from the aortic arch, is more clearly viewable in the MPR image (b). Fig. 2. Pre-operative CT-Volume Rendering image (a) demonstrates the anomalous origin of the branches of the aortic arch: from left to right can be seen the left subclavian artery (LS), left and right carotid arteries (LC-RC) from the common trunk and aberrant right subclavian artery (RS). The post-operative image (b) demonstrates the perfect outcome after reconstructive surgery: the aberrant artery was ligated at its origin and the proximal portion was resected; the distal portion was carefully trimmed and subsequently anastomized with the right carotid artery. Artifacts from metallic clips were removed in postprocessing.