Asymptomatic right-sided aortic arch in a Nigerian woman: a case report and literature review.

Idowu BM1*
1Department of Radiology, Union Diagnostics and Clinical Services, 37, Tejuosho Street, Yaba, Lagos State, Nigeria.
*Correspondence: Dr. Idowu, Bukunmi Michael;

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Background: Right-sided aortic arch (RAA) is a rare congenital anomaly of the cardiovascular system that stems from the persistence of the right fourth branchial arch. It occurs in < 0.1% of the population. RAA with an aberrant left subclavian artery is the most frequent type. The associated aberrant left subclavian artery occurs in about 50% of RAA cases. Anomalies of the great arteries (e.g., Fallot’s tetralogy) are common when RAA occurs in a normal visceral situs setting. By contrast, some cases of RAA remain asymptomatic throughout life. Echocardiography, multidetector cardiac CT, cardiac MRI, and cardiac catheterisation are the cornerstone of investigation in RAA cases.
Case presentation: This is a case report of an asymptomatic right-sided aortic arch without associated congenital anomalies detected incidentally in an adult during a pre-employment medical examination. The patient was symptomless; therefore, no treatment was given.
Conclusion: Very few cases of RAA in adults are entirely asymptomatic, as reported in this case. A review of the literature yielded scanty reports of aortic arch anomalies among Nigerians (paediatric and adults). In the previous decade (2011–2020), there were at least 32 case reports of RAA in adults. Of this number, only one was completely asymptomatic like this case report. This report might be the first documentation of an asymptomatic isolated RAA in a Nigerian.

Keywords: Right-sided aortic arch, Aortic arch variant, Cardiovascular anomalies, Computerised tomography, Case report.

Cite this article: Idowu BM. Asymptomatic right-sided aortic arch in a Nigerian woman: a case report and literature review. Yen Med J. 2021;3(1):148–152.


  1. Cinà CS, Althani H, Pasenau J, Abouzahr L. Kommerell’s diverticulum and right-sided aortic arch: a cohort study and review of the literature. J Vasc Surg. 2004;39:131–139.
  2. Priya S, Thomas R, Nagpal P, Sharma A, Steigner M. Congenital anomalies of the aortic arch. Cardiovasc Diagn Ther. 2018;8:S26–S44.
  3. Glew D, Hartnell GG. The right aortic arch revisited. Clin Radiol. 1991;43:305–307.
  4. D’Antonio F, Khalil A, Zidere V, Carvalho JS. Fetuses with right aortic arch: a multicenter cohort study and meta-analysis. Ultrasound Obstet Gynecol. 2016;47:423–432.
  5. Arazińska A, Polguj M, Szymczyk K, Kaczmarska M, Trębiński Ł, Stefańczyk L. Right aortic arch analysis – Anatomical variant or serious vascular defect? BMC Cardiovasc Disord. 2017;17:102.
  6. Hastreiter AR, D’Cruz IA, Cantez T, Namin EP, Licata R. Right-sided aorta. I. Occurrence of right aortic arch in various types of congenital heart disease. II. Right aortic arch, right descending aorta, and associated anomalies. Br Heart J. 1966;28:722–739.
  7. Payne DNR, Lincoln C, Bush A. Right sided aortic arch in children with persistent respiratory symptoms. BMJ. 2000;321:687–688.
  8. Onalo R, Orogade A, Ogala W, Igashi J, Hamidu A, Ekwem L, et al. Double aortic arch presenting as acute upper airway obstruction in a Nigerian newborn: A case report. J Med Med Sci. 2010;1:526–529.
  9. Ekure EN, Adeyemo AA. Clinical Epidemiology and Management of Congenital Heart Defects in a Developing Country. Congenit Heart Dis. 2015;46–56. DOI: 10.1159/000375204.
  10. Ekure EN, Bode-Thomas F, Sadoh WE, Orogade AA, Otaigbe BE, Ujunwa F, et al. Congenital Heart Defects in Nigerian Children: Preliminary Data From the National Pediatric Cardiac Registry. World J Pediatr Congenit Heart Surg. 2017;8:699–706.
  11. Abdulkadir M, Abdulkadir Z. A systematic review of trends and patterns of congenital heart disease in children in Nigeria from 1964–2015. Afr Health Sci. 2016;16:367–377.
  12. Chinawa JM, Obu HA, Eke CB, Eze JC. Pattern and clinical profile of children with complex cardiac anomaly at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Niger J Clin Pract. 2013;16:462–467.
  13. Animasahun BA, Madise-Wobo AD, Falase BA, Omokhodion SI. The burden of Fallot’s tetralogy among Nigerian children. Cardiovasc Diagn Ther. 2016;6:453–458.
  14. Animasahun BA, Madise-Wobo AD, Omokhodion SI, Njokanma OF. Children With Tetralogy of Fallot in an Urban Centre in Africa. J Cardiovasc Thorac Res. 2015;7:168–171.
  15. Prabhu S, Kasturi S, Mehra S, Tiwari R, Joshi A, John C, et al. The aortic arch in tetralogy of Fallot: types of branching and clinical implications. Cardiol Young. 2020;30:1144–1150.
  16. Qaqish N, Weerakkody Y. Tetralogy of Fallot | Radiology Reference Article. Radiopaedia. Available from: Accessed January 23, 2021.
  17. Stojanovska J, Cascade PN, Chong S, Quint LE, Sundaram B. Embryology and Imaging Review of Aortic Arch Anomalies. J Thorac Imaging. 2012;27:73–84.
  18. Kau T, Sinzig M, Gasser J, Lesnik G, Rabitsch E, Celedin S, et al. Aortic development and anomalies. Semin Interv Radiol. 2007;24:141–152.
  19. Rosen RD, Bordoni B. Embryology, Aortic Arch. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020. Available from: Accessed January 22, 2021.
  20. Zhyvotovska A, Yusupov D, Abdul R, Chandrakumar H, Hartt A, Akter K, et al. Right-sided Aortic Arch with Aberrant Left Subclavian Artery in a Pregnant Female: A Case Report and Literature Review. Am J Med Case Rep. 2020;8:143–147.
  21. Edwards JE. Anomalies of the derivatives of the aortic arch system. Med Clin North Am. 1948;32:925–949.
  22. Han JJ, Sohn S, Kim HS, Won TH, Ahn JH. A vascular ring: right aortic arch and descending aorta with left ductus arteriosus. Ann Thorac Surg. 2001;71:729–731.
  23. Stewart JR, Kincaid OW, Titus JL. Right aortic arch: plain film diagnosis and significance. Am J Roentgenol Radium Ther Nucl Med. 1966;97:377–89.
  24. Silit E, Mutlu H, Karaman B, Basekim CC. MR angiography of the anomalous branching of aortic arch and left subclavian artery arising from Kommerell’s diverticulum. Case report. Int Angiol. 2004;23:89–91.
  25. Türkvatan A, Büyükbayraktar FG, Olçer T, Cumhur T. Congenital anomalies of the aortic arch: evaluation with the use of multidetector computed tomography. Korean J Radiol. 2009;10:176–184.
  26. Weinberg P. Aortic Arch Anomalies. J Cardiovasc Magn Reson. 2006;8:633–643.
  27. Lee C-H, Son J-W, Park J-S. Comprehensive three-dimensional analysis of right-sided aortic arch with multiple vascular anomalies. BMC Cardiovasc Disord. 2014;14:104.
  28. Mubarak MY, Kamarul AT, Noordini MD. Right-sided Aortic Arch with Aberrant Left Subclavian Artery from Kommerell’s Diverticulum. Iran J Radiol. 2011;8:103–106.
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