Cor Vasa 2025, 67(Suppl.3):71-75 | DOI: 10.33678/cor.2025.036

Thoracic aortic aneurysm with an aberrant right subclavian artery and truncus bicaroticus

Carlos Daniel Quintana Baños^a, Štefan Lukačín^a, Tomáš Toporcer^a, Adrián Kolesár^a, Matej Moščovič^b, Peter Šafár^a

^a Department of Heart Surgery, Medical Faculty of Pavol Jozef Šafárik University and East Slovak Institute for Cardiovascular Diseases, Košice, Slovakia

^b Department of Angiology, Medical Faculty of Pavol Jozef Šafárik University and East Slovak Institute for Cardiovascular Diseases, Košice, Slovakia

Introduction: Arteria lusoria, or aberrant right subclavian artery (ARSA), is an anomaly of origin of the supra-aortic branches with an estimated incidence of 0.2-1.7%. 8% of these patients with ARSA go on to develop a thoracic aortic aneurysm, in contrast to 4.4% of the population without an aortic arch anomaly.

Case report: This case report presents a 56-year-old male, without associated comorbidities, who presented with an aortic arch anomaly composed of a truncus bicaroticus with a concomitant aberrant right subclavian artery without Komerell diverticulum and with a retroesophageal course, in association with an extensively calcified saccular aneurysm of the descending thoracic aorta, found incidentally on imaging performed for another reason. The patient underwent a multidisciplinary 2-stage operation consisting of an aortic debranch- ing and extra-anatomical bypass followed by Amplatzer occlusion of ARSA and TEVAR exclusion of the aneurysm. Discussion and conclusion: The patient was finally discharged on the 15th post-operative day in good condition. Hybrid approaches in surgical treatment of aortic arch anomalies offer a safe and effective therapeutic option.

Keywords: Aberrant right subclavian artery, Aortic debranching, Arteria lusoria, TEVAR

Received: February 3, 2025; Revised: February 3, 2025; Accepted: March 9, 2025; Prepublished online: June 2, 2012; Published: September 1, 2025  Show citation