Surgical Repair of a Giant Aberrant Artery Aneurysm in an Adult with Type B Interrupted Aortic Arch

Interrupted aortic arch (IAA) is a rare congenital anomaly usually diagnosed in infancy and associated with intracardiac defects, making survival into adulthood without repair exceptional. We report the case of a 62-year-old woman with longstanding hypertension who presented with progressive dyspnea and dysphagia. Computed tomography angiography identified a type B IAA associated with a giant 96-mm aneurysm arising from an aberrant retroesophageal artery connecting the right subclavian artery to the descending thoracic aorta, without associated cardiac abnormalities. Surgical management consisted of isolated resection of the aneurysmal segment and placement of a 14-mm Dacron graft, without reconstruction of the aortic arch given the patient's age and stable hypertension. The postoperative course was uneventful, and follow-up imaging showed stable repair with complete symptom resolution. This case highlights the possibility of long-term survival without restoration of normal aortic anatomy, and suggests that a tailored, complication-focused surgical approach may be appropriate in selected adult patients.