B has a right-sided aortic arch with an aberrant left subclavian artery at T4 that, with the ligamentum arteriosum
and left pulmonary artery, form a vascular ring impinging around the esophagus.
Another common site is the descending thoracic aorta just below the ligamentum arteriosum
Patients were assigned into four VR subtypes: (1) Double aortic arch (DAA), (2) pulmonary artery sling (PAS), (3) right aortic arch with a persistent left ligamentum arteriosum
(RALL), and (4) others.
Left aortic arch and right ligamentum arteriosum
causing esophageal obstruction in a dog.
Congenital absence of the pericardium and its relationship to the ligamentum arteriosum
The ductus arteriosus, which becomes the nonfunctional vestige known as the ligamentum arteriosum
, closes a few weeks after birth as does the ductus arteriosus.
4L: Includes nodes to the left of the left lateral border of the trachea, medial to the ligamentum arteriosum
The commonest cause has been thought to be mitral valve stenosis or prolapse leading to left atrial dilatation that compresses the recurrent laryngeal nerve as it hooks around the aorta next to the ligamentum arteriosum
and courses up in the groove between the trachea and esophagus.
Cardiovascular trauma in children usually results in (a) aortic disruption at the level of the ligamentum arteriosum
, (b) cardiac rupture, or (c) laceration.
The two most common aortic arch anomalies that cause airway compression are (1) a double aortic arch and (2) a right aortic arch with an aberrant left subclavian artery and left ligamentum arteriosum
Diagnostic workup in a 2-year-old girl with acute foreign body impaction into the esophagus and frequent respiratory tract infections revealed right descending aortic arch with ligamentum arteriosum
as the cause of extrinsic esophagealtracheal compression.
It hooks under the arch of aorta, posterior to the ligamentum arteriosum
before ascending towards the neck between the trachea and the esophagus.