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Asian Cardiovasc Thorac Ann 2003;11:376
© 2003 Asia Publishing EXchange Ltd

IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY

Dysphagia Lusorum

Varma Praveen, MCh, Mohanraj Anbarasu, MCh, Vitthal Gadhingldajkar Sreenivas, MD, Kurur Sankaran Neelakandhan, MCh

Department of Cardiovascular Surgery, Sree Chitra Thirunal Institute for Medical Sciences & Technology, Trivandrum, India

For reprint information contact: Varma Praveen, MCh Tel: 91 471 244 4496 Fax: 91 471 244 6433 email: pkvarma{at}sctimst.ker.nic.in Sree Chitra Thirunal Institute for Medical Sciences & Technology, Trivandrum 695011, India.

A 65 years old post-menopausal lady was admitted with dysphagia for solids of one year duration. The patient underwent closure of atrial septal defect in 1984. Barium swallow showed extrinsic compression of esophagus at D4 level with delay in emptying (Figure 1Go). Aortogram showed aberrant right subclavian artery passing posterior to esophagus, compressing the barium filled esophagus (Figure 2Go). The right subclavian artery was mobilized under the esophagus, through right thoracotomy, and divided at the origin. At one year follow up, she was free of symptoms.



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  		Figure 1. Barium swallow shows extrinsic compression at D4 level which is the Hall-mark of aberrant (R) subclavian artery.

 


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  		Figure 2. Aortogram shows compression of barium filled esophagus by an aberrant right subclavian artery. Vertebral artery on the left side was seen arising as a separate branch of aortic arch.

 





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