case_images: PMC6350440_01
case_images: (a) Computerized tomography angiography with three-dimensional reconstruction showing the double aortic arch with left predominance, (b) site of tracheal stenosis by extrinsic compression, (c) aortic arch in relation to mediastinal structures
case_images: ACA-22-83-g001.jpg
case_images: PMC6350440_01_ACA-22-83-g001.jpg
case_images: F1
case_images: High-resolution computerized tomography (CT) scan revealed a left dominant double aortic arch [Figure 1a] forming a complete vascular ring compressing the trachea just above the carina [Figure 1b]. At the time of radiological evaluation, the endotracheal tube needed to be pulled out proximal to the site of compression to clearly demarcate the site radiologically [Figure 1c].
case_images: The site of surgical division (AA: Ascending aorta, RA: Right arch, LA: Left arch, DA: Descending aorta)
case_images: ACA-22-83-g002.jpg
case_images: PMC6350440_01_ACA-22-83-g002.jpg
case_images: F2
case_images: Once all the arch vessels were identified and looped, the right arch was divided from the dominant left arch, just proximal to the origin of the left common carotid artery [Figure 2].