Double aortic arch associated with coarctation of the aorta; surgically treated patient.

Anomalies of the aortic arch system may assume many different anatomic patterns. Some are only of academic interest; others are of extreme clinical importance and may at times constitute an emergency requiring prompt surgical intervention to save life. The anomalies of the aortic arch system which produce symptoms and which require surgical treatment are of three types. First, there are the “vascular rings,” which are so disposed as to form a ring around or to press against the trachea, the esophagus or both; second, those anomalies which produce obstruction in one or another part of the aorta, namely coarctation; and third, persistent patent ductus arteriosus. The surgical correction of coarctation of the aorta has become a standard procedure and is ideally performed on young adults; occasionally this anomaly produces cardiac symptoms in early life necessitating surgical treatment to avert progressive, at times rapidly progressive, heart failure. The patient on whom data are reported here had the unusual combination of a vascular ring in the form of a double aortic arch with stenosis of the right (posterior) arch and coarctation of the left (anterior) arch.