An unusually long ligamentum arteriosum

Short-length ligamentum arteriosum as a cause of congenital narrowing of the left main stem bronchus

An entity that has received little attention as cause or recurrent respiratory disorder is the narrowing of the left main stem bronchus. When not associated with congenital heart disorders, this condition has been ascribed to primary localized malacia of the bronchial cartilages or to the anterior displacement of the descending aorta in front to the adjacent vertebral bodies. Four girls were evaluated for recurrent/chronic respiratory symptoms. A pulsatile extrinsic compression on the posterior bronchial wall of the left main stem bronchus was detected, pressed between the descending aorta, posteriorly, and the left pulmonary artery, anteriorly. The two arteries were closely linked together by a short-length ligamentum that was resected, allowing the mobilization of the aorta with posterior aortopexy, stabilizing the space created between the pulmonary artery and the descending aorta. The reduced compression on the left main bronchus resulted in the enlargement of its caliber and in a marked improvement of the respiratory symptoms. Pediatr Pulmonol. 2016;51:1356-1361. © 2016 Wiley Periodicals, Inc.

Right-sided aorta: a cadaver report and brief discussion of human aortic arch anomalies

We observed an unusual right-sided aorta during routine laboratory dissection. The short aortic arch passed to the right side of the esophagus and trachea and had four branches, from proximal to distal: left common carotid, right common carotid, right subclavian, left subclavian arteries. The ligamentum arteriosum connected the pulmonary trunk to the left subclavian artery and lay to the left of the esophagus and trachea. The left recurrent laryngeal nerve passed under the ligamentum arteriosum while the right recurrent laryngeal nerve passed under the aortic arch. The descending thoracic aorta was situated near the midline, anterior to the vertebral bodies; consequently, the right posterior intercostal arteries were shorter than normal. The large veins of the thorax and the other thoracic organs appeared normal.