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October 1969

Right Cervical Aortic Arch With Left Descending Aorta: Case Report and Review of the Literature

Author Affiliations

San Francisco and Oakland, Calif
From the Combined Department of Pediatrics, Children's Hospital and Adult Medical Center, Pacific Medical Center, and Department of Cardio-Vascular Surgery, Pacific Medical Center, San Francisco; and the Department of Pediatrics, The Permanente Medical Group, Kaiser Foundation Hospital, Oakland, Calif.

Am J Dis Child. 1969;118(4):642-648. doi:10.1001/archpedi.1969.02100040644021

THE NORMAL aortic arch is an intrathoracic structure derived embryologically from the left fourth branchial arch. In rare individuals, the aortic arch appears to be derived from the right third branchial arch. In such instances, the aortic arch extends well into the neck and the pattern of the brachiocephalic arteries is altered. This unusual anomaly manifests certain characteristic clinical findings.

Report of a Case  A white female infant, delivered without incident after an uneventful, full-term gestation, appeared normal at birth and weighed 3,090 gm (6 lb 13 ounces). At 1 month of age, her weight was 3,508 gm (7 lb 11¾ ounces). The only abnormality found at that time, an inconstant systolic murmur heard along the left sternal border, was also heard at each monthly examination during the first year of life. At age 5 months, blood pressure was 116/60 mm Hg in the right arm and 122/84 mm Hg