PMC3742065_01
Maximum intensity projection (MIP) of chest CT after contrast injection. Origin of the left common carotid artery, arising from the ascending aorta as the first branch of the aortic arch (black arrow) and partial view of the Kommerell diverticulum with kinking of the normal-sized distal left subclavian artery (white arrow) are seen. Note the dense pericardial effusion due to pericardial hemorrhage (asterisk)
10.1177_2047981613476283-fig1.jpg
PMC3742065_01_10.1177_2047981613476283-fig1.jpg
ARR476283F1
We found a complex vascular anomaly of the aorta and the supra-aortic branches with right-sided aortic arch and aneurysmal dilatation of the vascular origin of the aberrant left subclavian artery (Figs. 1-4).
Maximum intensity projection (MIP) of chest CT after contrast injection. Maximum diameter of the aneurysm at the aberrant origin of the left subclavian artery is 3.3 cm (white arrows). The black arrow points at the aortic arch with a prominent brachiocephalic trunk (black arrowhead). Note hemopericardium (asterisk)
10.1177_2047981613476283-fig2.jpg
PMC3742065_01_10.1177_2047981613476283-fig2.jpg
ARR476283F2
We found a complex vascular anomaly of the aorta and the supra-aortic branches with right-sided aortic arch and aneurysmal dilatation of the vascular origin of the aberrant left subclavian artery (Figs. 1-4).
Volume-rendering image clearly shows the Kommerell diverticulum (thin, white arrow). Note the left common carotid artery arising from the ascending aorta (white block arrow). The arrowhead points to the right-sided descending aorta
10.1177_2047981613476283-fig3.jpg
PMC3742065_01_10.1177_2047981613476283-fig3.jpg
ARR476283F3
We found a complex vascular anomaly of the aorta and the supra-aortic branches with right-sided aortic arch and aneurysmal dilatation of the vascular origin of the aberrant left subclavian artery (Figs. 1-4).
Kommerell diverticulum (asteriks) with tracheal narrowing
10.1177_2047981613476283-fig4.jpg
PMC3742065_01_10.1177_2047981613476283-fig4.jpg
ARR476283F4
We found a complex vascular anomaly of the aorta and the supra-aortic branches with right-sided aortic arch and aneurysmal dilatation of the vascular origin of the aberrant left subclavian artery (Figs. 1-4).
Chest CT of ascending aorta. (a) Chest CT at the level of the aortic root (without ECG triggering). Motion artefacts at the aortic root (white arrows) without evidence of aortic dissection. Note hemopericardium (black asterisk). (b) ECG-triggered study at the same level shows dissection of the ascending aorta (black asterisk) with no evidence of active bleeding. The black arrow points to the entry of the dissection
10.1177_2047981613476283-fig5.jpg
PMC3742065_01_10.1177_2047981613476283-fig5.jpg
ARR476283F5
Due to motion artifacts at the level of the aortic root, no intimal flap was evident (Fig. 5a). Stanford classification (DeBakey type II) with pericardial tamponade (Fig. 5b). Surgery with graft replacement was performed immediately.