open access

Vol 82, No 2 (2023)
Case report
Submitted: 2022-02-23
Accepted: 2022-03-29
Published online: 2022-04-20
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A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology

P. Ostrowski1, S. Popovchenko1, M. Bonczar1, T. Mroczek2, J. A. Walocha1, M. P. Zarzecki1
·
Pubmed: 35481702
·
Folia Morphol 2023;82(2):400-406.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Department of Paediatric Cardiac Surgery, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 82, No 2 (2023)
CASE REPORTS
Submitted: 2022-02-23
Accepted: 2022-03-29
Published online: 2022-04-20

Abstract

A left circumflex aorta (LCA) is an extremely rare variation of the thoracic aorta. It is distinguished by a retroesophageal descending aorta that subsequently travels down the right side of the thoracic vertebrae towards the aortic hiatus. Nonetheless, its embryological origin ought not to be overly generalised, but each case should be considered individually due to its unique vascular patterns. This study presents a description of a LCA in a 94-year-old male cadaver. The dissection revealed the descending aorta posteriorly from the trachea and oesophagus and then laterally on the right from the thoracic vertebral bodies. The branching pattern of the aortic arch was typical, so was the course of the left and right recurrent laryngeal nerves. However, the thoracic duct was placed on the right, and drained into the right internal carotid vein. Due to the normal appearance of the ascending part and the arch of the aorta, it is safe to presume that the variation originated from the persistent right dorsal aorta, with the retroesophageal part from the persistent left dorsal aorta.
Detailed understanding of the variations of the thoracic aorta, and the anomalies associated with the LCA, can help to improve management of these conditions, and with that, improve patients’ overall outcomes. Patients with a LCA, or another vascular ring, can either be asymptomatic or present with oesophageal and/or tracheal compression symptoms. Management of this anomaly consists namely of ligation of the patent ductus arteriosus/ligamentum arteriosum and aortic uncrossing.

Abstract

A left circumflex aorta (LCA) is an extremely rare variation of the thoracic aorta. It is distinguished by a retroesophageal descending aorta that subsequently travels down the right side of the thoracic vertebrae towards the aortic hiatus. Nonetheless, its embryological origin ought not to be overly generalised, but each case should be considered individually due to its unique vascular patterns. This study presents a description of a LCA in a 94-year-old male cadaver. The dissection revealed the descending aorta posteriorly from the trachea and oesophagus and then laterally on the right from the thoracic vertebral bodies. The branching pattern of the aortic arch was typical, so was the course of the left and right recurrent laryngeal nerves. However, the thoracic duct was placed on the right, and drained into the right internal carotid vein. Due to the normal appearance of the ascending part and the arch of the aorta, it is safe to presume that the variation originated from the persistent right dorsal aorta, with the retroesophageal part from the persistent left dorsal aorta.
Detailed understanding of the variations of the thoracic aorta, and the anomalies associated with the LCA, can help to improve management of these conditions, and with that, improve patients’ overall outcomes. Patients with a LCA, or another vascular ring, can either be asymptomatic or present with oesophageal and/or tracheal compression symptoms. Management of this anomaly consists namely of ligation of the patent ductus arteriosus/ligamentum arteriosum and aortic uncrossing.

Get Citation

Keywords

left circumflex aorta, thoracic duct, anatomy, embryology, anatomical variation

About this article
Title

A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology

Journal

Folia Morphologica

Issue

Vol 82, No 2 (2023)

Article type

Case report

Pages

400-406

Published online

2022-04-20

Page views

2318

Article views/downloads

889

DOI

10.5603/FM.a2022.0043

Pubmed

35481702

Bibliographic record

Folia Morphol 2023;82(2):400-406.

Keywords

left circumflex aorta
thoracic duct
anatomy
embryology
anatomical variation

Authors

P. Ostrowski
S. Popovchenko
M. Bonczar
T. Mroczek
J. A. Walocha
M. P. Zarzecki

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