The Aberrant Right Subclavian Artery and Bi-Carotid Trunk with the Absence of Brachiocephalic Trunk: A Case Report

BACKGROUND: Typical branches of the aortic arch include the left common carotid artery, the left subclavian artery, and the brachiocephalic trunk. Variations in this pattern may be associated with pathologies. This report describes one case of anatomical variation of the aorta and great vessels. METHODS: Dissection of a cadaveric mediastinum, including removal of the anterior thoracic wall, was performed to expose the aorta and great vessels. RESULTS: Examination of the aortic arch revealed no brachiocephalic trunk. The right subclavian artery originated directly from the right side of the thoracic aorta. The right subclavian artery then coursed posterior to the esophagus before giving rise to its typical branches. Both the right and left common carotid arteries originated from a single trunk off the aortic arch. CONCLUSION: The presence of both an aberrant right subclavian artery and a bi-carotid trunk is a rare congenital anomaly. Such anomalies are often asymptomatic and discovered incidentally, but anatomical variation is clinically significant given its potential to cause compressive symptoms or suggest the presence of other congenital differences. Awareness of such variation is essential for clinicians in anatomy, cardiology, radiology, and surgery to ensure accurate diagnosis and appropriate management.