11/21/2023 0 Comments Types of aortic archPulmonary embolism was suspect and a contrast-enhanced computed tomography (CT) chest examination was performed by a 64-slice CT scanner (Lightspeed General Electric Healthcare, Waukesha, WI). In medical history, the patient referred to be affected by left renal oncocytoma, not subjected to any type of therapy, monitored, and stable in the various controls.īlood laboratory test showed: creatinine: 0.80 mg/dL (normal value (nv): 0.55-1.22 mg/dL) fibrinogen 365.00 mg/dL (nv 200-400 mg/dL) D-Dimer: 3243.00 ng/mL (nv 0-500 ng/mL) international normalized ratio: 0.97 (0.8-1.2) creatinin kinase: 0.90 mg/mL (nv <3.4) myoglobin: 38.00 ng/mL (nv <108) troponin 6.0 ng/mL (nv <15.6). She had no history of cardiovascular disease. We report a case of a 79 years old woman with right aortic arch with mirror image branching (RAMI) discovered as incidental finding.Ī 79-years-old-female was admitted to the Emergency Department for dyspnea and chest pain. This anomaly results from regression of the left dorsal aorta distal to the origin of the seventh intersegmental artery, so that the left fourth arch becomes the proximal subclavian artery rather than the definitive aortic arch. RAMI is the second most common form of a right-sided arch, after right arch with ALSA. In accordance with this, the Edwards classification describes 3 types of right aortic arch (RAA): RAA with mirror image branching (RAMI), RAA with aberrant left subclavian artery (ALSA) and RAA with isolation of the LSA. It is possible to describe most anomalies of the aortic arch by postulating regression of a segment that would normally persist, and/or persistence of a segment that would normally regress. Six paired primitive aortic arches develop between the ventral and dorsal aortae. According to Edwards’ hypothetical embryonic double aortic arch model, each primitive aorta consists of a ventral and a dorsal segment. They result from aberrant development of one or more components of the embryonic pharyngeal arch system. Congenital anomalies of the aortic arch complex include left-sided, right-sided, and double aortic arches, with various branching patterns of the great vessels.
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