Persistent Right Aortic Arch in a 3-month-old Labrador Retriever
A 3-month-old Labrador retriever presented to Cornell's Soft Tissue Surgery Service with a history of regurgitation that began after he was introduced to solid food. Attempts to feed the patient a frequent elevated slurry diet failed to resolve regurgitation. A barium swallow study and thoracic radio graphs supported the presumptive diagnosis of a persistent right aortic arch. On presentation to Cornell's Soft Tissue Surgery Service, the patient appeared bright and alert, and in great condition. A computed tomography angiogram and 3D reconstruction of his heart supported the diagnosis of a Type 1 persistent right aortic arch consisting of a right sided aortic arch with an aberrant right subclavian artery, bicarotid trunk, aberrant left subclavian artery, and a left sided non-patent ligamentum ateriosum. A left 4th intercostal thoracotomy was performed. The ligamentum aiteriosum was identified attached proximally to the persistent right aortic arch and distally to the left pulmonary artery. Two ligatures were placed over the ligamentum arteriosum and the ligament was transected between the ligatures to release constriction over the esophagus. The aberrant left subclavian artery was identified and found not to be associated with any esophageal entrapment. The patient recovered from anesthesia without complications and was discharged two days after surgery.