Anomalies of the aortic arch and its branches comprise a wide variety of conditions2 giving rise to varied symptoms and signs. Most of these anomalies are amenable to surgical correction and relief of symptoms. This paper reports a case with four distinct vascular anomalies: anomalous innominate and right subclavian arteries and coarctation of the aorta with the anomalous subclavian artery emerging from the aorta at the site of the coarctation.
History and Incidence
According to Stauffer and Pote,26 Bayfield, in 1789, reported the first case of a right subclavian artery originating as the fourth branch of the aortic arch. He reported in detail the clinical and postmortem findings. In 1934 a total of 260 cases had been reported in the literature.9 More recently, Gross and associates15 began the surgical attack on this condition and reported 11 cases, 10 of which were of aberrant right subclavian arteries