Right sided aortic arch is seen with an aberrant origin of the left subclavian artery, which is seen arising as a last branch from the arch. There is focal dilatation at its origin, consistent with a Kommerell's diverticulum.
Significant indentation and narrowing of the trachea is seen, which could probably be an explanation for patient's symptoms.
Additional vascular variations are noted:
- left vertebral artery is originating from the left common carotid instead of subclavian artery
- right vertebral artery is originating directly from the arch of aorta, in between the origins of right common carotid and right subclavian artery