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Right aortic arch with mirror image branching

MedGen UID:
871216
Concept ID:
C4025695
Anatomical Abnormality
HPO: HP:0002627

Definition

The aortic arch crosses the right mainstem bronchus and not the left mainstem bronchus, but does not result in the creation of a vascular ring. The first branch is the left brachiocephalic artery which divides into the left carotid artery and left subclavian artery, the second branch is the right carotid artery, the third branch is the right subclavian artery. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRight aortic arch with mirror image branching

Conditions with this feature

DiGeorge syndrome
MedGen UID:
4297
Concept ID:
C0012236
Disease or Syndrome
Individuals with 22q11.2 deletion syndrome (22q11.2DS) can present with a wide range of features that are highly variable, even within families. The major clinical manifestations of 22q11.2DS include congenital heart disease, particularly conotruncal malformations (ventricular septal defect, tetralogy of Fallot, interrupted aortic arch, and truncus arteriosus), palatal abnormalities (velopharyngeal incompetence, submucosal cleft palate, bifid uvula, and cleft palate), immune deficiency, characteristic facial features, and learning difficulties. Hearing loss can be sensorineural and/or conductive. Laryngotracheoesophageal, gastrointestinal, ophthalmologic, central nervous system, skeletal, and genitourinary anomalies also occur. Psychiatric illness and autoimmune disorders are more common in individuals with 22q11.2DS.
Velocardiofacial syndrome
MedGen UID:
65085
Concept ID:
C0220704
Disease or Syndrome
Individuals with 22q11.2 deletion syndrome (22q11.2DS) can present with a wide range of features that are highly variable, even within families. The major clinical manifestations of 22q11.2DS include congenital heart disease, particularly conotruncal malformations (ventricular septal defect, tetralogy of Fallot, interrupted aortic arch, and truncus arteriosus), palatal abnormalities (velopharyngeal incompetence, submucosal cleft palate, bifid uvula, and cleft palate), immune deficiency, characteristic facial features, and learning difficulties. Hearing loss can be sensorineural and/or conductive. Laryngotracheoesophageal, gastrointestinal, ophthalmologic, central nervous system, skeletal, and genitourinary anomalies also occur. Psychiatric illness and autoimmune disorders are more common in individuals with 22q11.2DS.
Matthew-Wood syndrome
MedGen UID:
318679
Concept ID:
C1832661
Disease or Syndrome
Syndromic microphthalmia-9 (MCOPS9), also referred to as pulmonary hypoplasia-diaphragmatic hernia-anophthalmia-cardiac defect, is characterized by bilateral clinical anophthalmia, pulmonary hypoplasia/aplasia, cardiac malformations, and diaphragmatic defects. The phenotype is variable, ranging from isolated clinical anophthalmia or microphthalmia to complex presentations involving the cardiac, pulmonary, diaphragmatic, and renal systems. At its most severe, infants are born without pulmonary structures and die soon after birth (Marcadier et al., 2015).
Atrioventricular septal defect, susceptibility to, 2
MedGen UID:
381193
Concept ID:
C1853508
Finding
Any atrioventricular septal defect in which the cause of the disease is a mutation in the CRELD1 gene.
Aortic arch anomaly-facial dysmorphism-intellectual disability syndrome
MedGen UID:
350734
Concept ID:
C1862682
Disease or Syndrome
A developmental anomaly characterized at birth by the presence of right-sided aortic arch, craniofacial dysmorphism (microcephaly, asymmetric, facial bones, broad forehead, borderline hypertelorism, nasal septum deviation, large nasal cavity, large, posteriorly rotated ears, and microstomia with downturned corners), and intellectual disability. These features were observed in 4 members of one family, involving 2 successive generations, suggesting an autosomal dominant mode of transmission. There have been no further descriptions in the literature since 1968.

Professional guidelines

PubMed

Gao J, Zhu J, Pei Q, Li J
Arch Gynecol Obstet 2017 May;295(5):1291-1295. Epub 2017 Mar 27 doi: 10.1007/s00404-017-4310-3. PMID: 28345111

Recent clinical studies

Etiology

Verma M, Ojha V, Mukherjee A, Kumar S, Ramakrishnan S, Jagia P
J Card Surg 2022 Jul;37(7):1928-1936. Epub 2022 Apr 8 doi: 10.1111/jocs.16468. PMID: 35396763
Dong SZ, Zhu M
J Matern Fetal Neonatal Med 2019 Apr;32(7):1057-1062. Epub 2017 Nov 13 doi: 10.1080/14767058.2017.1399116. PMID: 29096572
Oztunc F, Ugan Atik S, Dedeoglu R, Yuksel MA, Madazlı R
J Obstet Gynaecol 2018 Jul;38(5):647-651. Epub 2018 Feb 12 doi: 10.1080/01443615.2017.1399989. PMID: 29430994
Pauliukas PA
Angiol Sosud Khir 2005;11(2):131-4. PMID: 16037813
van Son JA, Julsrud PR, Hagler DJ, Sim EK, Pairolero PC, Puga FJ, Schaff HV, Danielson GK
Mayo Clin Proc 1993 Nov;68(11):1056-63. doi: 10.1016/s0025-6196(12)60898-2. PMID: 8231269

Diagnosis

Verma M, Ojha V, Mukherjee A, Kumar S, Ramakrishnan S, Jagia P
J Card Surg 2022 Jul;37(7):1928-1936. Epub 2022 Apr 8 doi: 10.1111/jocs.16468. PMID: 35396763
Yang Z, Zhou L
Echocardiography 2019 Oct;36(10):1952-1955. Epub 2019 Aug 31 doi: 10.1111/echo.14466. PMID: 31471981
Gao J, Zhu J, Pei Q, Li J
Arch Gynecol Obstet 2017 May;295(5):1291-1295. Epub 2017 Mar 27 doi: 10.1007/s00404-017-4310-3. PMID: 28345111
Hanneman K, Newman B, Chan F
Radiographics 2017 Jan-Feb;37(1):32-51. Epub 2016 Nov 18 doi: 10.1148/rg.2017160033. PMID: 27860551
Nakata M, Suzuki Y, Hotta N, Sunasaka T, Numa F
J Obstet Gynaecol Res 2013 May;39(5):1077-80. Epub 2013 Mar 17 doi: 10.1111/jog.12010. PMID: 23496770

Prognosis

Yang Z, Zhou L
Echocardiography 2019 Oct;36(10):1952-1955. Epub 2019 Aug 31 doi: 10.1111/echo.14466. PMID: 31471981
Gao J, Zhu J, Pei Q, Li J
Arch Gynecol Obstet 2017 May;295(5):1291-1295. Epub 2017 Mar 27 doi: 10.1007/s00404-017-4310-3. PMID: 28345111
Hanneman K, Newman B, Chan F
Radiographics 2017 Jan-Feb;37(1):32-51. Epub 2016 Nov 18 doi: 10.1148/rg.2017160033. PMID: 27860551
Pauliukas PA
Angiol Sosud Khir 2005;11(2):131-4. PMID: 16037813
van Son JA, Julsrud PR, Hagler DJ, Sim EK, Pairolero PC, Puga FJ, Schaff HV, Danielson GK
Mayo Clin Proc 1993 Nov;68(11):1056-63. doi: 10.1016/s0025-6196(12)60898-2. PMID: 8231269

Clinical prediction guides

Li X, Li X, Hu K, Yin C
J Matern Fetal Neonatal Med 2017 Jun;30(11):1366-1371. Epub 2016 Aug 10 doi: 10.1080/14767058.2016.1214126. PMID: 27440228
Holmes KW, Bluemke DA, Vricella LA, Ravekes WJ, Kling KM, Spevak PJ
Pediatr Cardiol 2006 May-Jun;27(3):316-20. doi: 10.1007/s00246-005-1118-x. PMID: 16565909
McElhinney DB, Hoydu AK, Gaynor JW, Spray TL, Goldmuntz E, Weinberg PM
Pediatr Cardiol 2001 Jul-Aug;22(4):285-91. doi: 10.1007/s002460010231. PMID: 11455394
van Son JA, Julsrud PR, Hagler DJ, Sim EK, Puga FJ, Schaff HV, Danielson GK
Ann Thorac Surg 1994 Mar;57(3):604-10. doi: 10.1016/0003-4975(94)90552-5. PMID: 8147628

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