Surgical treatment of dysphagia lusoria caused by an aberrant right subclavian artery: a case report and literature review

Abstract

Introduction. Dysphagia lusoria refers to dysphagia caused by an aberrant right subclavian artery (ARSA), a rare congenital anomaly of the aortic arch. This article presents a clinical case of symptomatic ARSA, accompanied by a comprehensive review of its anatomical, clinical, and therapeutic aspects. Material and methods. We present the case of a 54-year-old female patient diagnosed with dysphagia lusoria due to ARSA, who underwent surgical intervention after clinical and imaging evaluations. The literature was reviewed through PubMed using the keywords: “aberrant right subclavian artery”, “dysphagia lusoria”, and “arteria lusoria”. Results. The patient presented with progressive dysphagia, morning cough, fatigue, and weight loss. Imaging revealed ARSA compressing the esophagus, and the presence of a bicarotid trunk. Surgical correction involved right subclavian-tocarotid transposition, with complete resolution of symptoms. The literature review showed a modest grade of evidence regarding the management of patients with dysphagia lusoria, mostly including case reports and limited case series. Treatment is usually indicated in symptomatic patients, with options including open surgery or hybrid approaches. Conclusions. ARSA can cause significant esophageal symptoms in adults, representing a diagnostic challenge. Appropriate imaging and timely surgical intervention are crucial in symptomatic cases. Awareness of aortic anatomical variants is essential for both diagnosis and treatment planning.