A man in his eighth decade of life with a medical history of transthyretin cardiac amyloidosis and severe nonrheumatic aortic stenosis (stage D1) presented with symptoms of dysphagia for 8 months and an evaluation for transcatheter aortic valve replacement. Computed tomography angiography showed an anomalous right subclavian artery and bovine carotid trunk consistent with the diagnosis of arteria lusoria, Adachi and Williams classification type H-1 (Figure). This embryologic variant of an anomalous subclavian artery arising distal to the origin of the left subclavian artery on the aortic arch has an incidence of 0.5% to 2%.1,2 Arteria lusoria combined with truncus bicoriticus, or common origin of the carotid arteries, is rare with a prevalence of less than 0.05%. Arteria lusoria, which courses posterior to the esophagus with symptomatic impingement, is known as dysphagia lusoria.3 Surgical intervention should be considered in symptomatic cases and with complications from aneurysmal or arterial occlusive disease.
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Published Online: June 14, 2023. doi:10.1001/jamacardio.2023.1451
Corresponding Author: Damian Valencia, MD, Department of Cardiovascular Medicine, Kettering Health, Main Campus, 3535 Southern Blvd, Kettering, OH 45429 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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