Late development of esophageal compression from a vascular ring

Severe esophageal compression due to a vascular ring rarely develops after childhood. We report a case of a 57-year-old man with recent onset of dysphagia associated with right aortic arch, right descending aorta, and retroesophageal left subclavian artery arising from an arch diverticulum. Surgical repair was recommended for relief of symptoms and to prevent rupture of the diverticulum. The patient underwent left thoracotomy, division of the ligamentum arteriosum, and excision of the arch diverticulum. The left subclavian artery was reimplanted into the left common carotid artery through a separate neck incision. The patient had total relief of dysphagia postoperatively.