背景/目的:右主动脉弓(RAA)是主动脉弓(AA)的罕见变异,其特征是主动脉横穿右主支气管。在RAA中,降主动脉位于脊柱的右侧或左侧。当前的研究包括对希腊人群中RAA患病率的全面回顾性计算机断层扫描血管造影(CTA)调查。此外,我们将进行系统综述和荟萃分析,以阐明RAA常见和罕见的形态学变异.这项研究意义重大,因为它揭示了RAA在特定人群中的患病率和特征,为临床实践提供有价值的见解。方法:仔细研究了200个CTA是否存在RAA。此外,PubMed,谷歌学者,彻底搜索了Scopus在线数据库中有关AA形态学的研究。R编程语言和RStudio用于汇总患病率荟萃分析,同时进行了一些亚组分析。结果:原始研究:发现200个CTA(0.5%)的独特病例,形态不常见。以下分支从序列下的RAA发出:右锁骨下动脉(RSA),右颈总动脉(RCCA),左颈总动脉(LCCA),左椎动脉(LVA)与异常左锁骨下动脉(ALSA)共同起源。ALSA起源于憩室(Kommerel),并遵循食道后。系统评价和荟萃分析:62项研究(72,187例)符合纳入标准。具有镜像形态的RAA的合并患病率估计为0.07%,与ALSA的RAA估计为<0.01%。结论:AA异常,特别是RAA,由于它们与发育性心脏异常和可能的介入并发症共存,因此提高了临床兴趣。先天性心脏异常,比如法洛四联症和卵圆孔未闭,与RAA镜像形态学共存。
Background/Objectives: The right-sided aortic arch (RAA) is an uncommon variation of the aortic arch (AA), characterized by the aorta crossing over the right main bronchus. In the RAA, the descending aorta can be found on either the right or left side of the spine. The current study comprises a comprehensive retrospective computed tomography angiography (CTA) investigation into the prevalence of the RAA within the Greek population. Additionally, we will conduct a systematic review and meta-analysis to elucidate both common and rare morphological variants of the RAA. This research is significant as it sheds light on the prevalence and characteristics of the RAA in a specific population, providing valuable insights for clinical practice. Methods: Two hundred CTAs were meticulously investigated for the presence of a RAA. In addition, the PubMed, Google Scholar, and Scopus online databases were thoroughly searched for studies referring to the AA morphology. The R programming language and RStudio were used for the pooled prevalence meta-analysis, while several subgroup analyses were conducted. Results: Original study: A unique case of 200 CTAs (0.5%) was identified with an uncommon morphology. The following branches emanated from the RAA under the sequence: the right subclavian artery (RSA), the right common carotid artery (RCCA), the left common carotid artery (LCCA), and the left vertebral artery (LVA) in common origin with the aberrant left subclavian artery (ALSA). The ALSA originated from a diverticulum (of Kommerell) and followed a retroesophageal course. Systematic Review and Meta-Analysis: Sixty-two studies (72,187 total cases) met the inclusion criteria. The pooled prevalence of the RAA with a mirror-image morphology was estimated at 0.07%, and the RAA with an ALSA was estimated at <0.01%. Conclusions: AA anomalies, specifically the RAA, raise clinical interest due to their coexistence with developmental heart anomalies and possible interventional complications. Congenital heart anomalies, such as the Tetralogy of Fallot and patent foramen ovale, coexisted with RAA mirror-image morphology.