Variation in the anatomy of the ligamentum arteriosum in a South African simple

ABSTRACT

The ligamentum arteriosum is a remnant of the ductus arteriosus, which connects the aortic arch and the pulmonary trunk during fetal life. Variation in the anatomy of the ligamentum arteriosum, its connections with the aorta and pulmonary trunk and the course of the left recurrent laryngeal nerve relative to the ligamentum arteriosum were investigated. Dissection of the superior mediastinum was performed on 40 cadavers. The anatomy of the ligamentum arteriosum and its relationship to the aortic arch, pulmonary trunk and left recurrent laryngeal nerve were documented. The dimensions of the ligamentum arteriosum were measured with a caliper. Ligamenta arteriosa in which presence of a lumen was suspected were examined histologically. Variation in the structure and size of the ligamenta arteriosa was found to be common. A 'line' on the luminal surface of the aorta at the attachment site of the ligamentum arteriosum was observed in 26%. A shallow fossa or depression was found on the luminal surface of the pulmonary trunk in all but one individual. The left recurrent laryngeal nerve was situated lateral to the ligamentum arteriosum in 97%. Variation in the anatomy of the ligamentum arteriosum was found to be common, whereas variation in the position of the left recurrent laryngeal nerve was rare. This information is relevant for surgeons to avoid accidental injury to variant structures. Remnants, in the form of 'lines' or depressions, of the anatomical association between the ductus arteriosus and the aorta and pulmonary trunk were present

RESUMEN

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