Persistent Right Aortic Arch Average Cost

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What is Persistent Right Aortic Arch?

During development, the aorta may not mature as it should. Typically, there is an embryonic branch that does not regress and instead wraps around the esophagus putting pressure on it. This leads to problems directly related to the abnormality, such as regurgitation, or secondary issues, such as breathing issues from aspiration pneumonia from regurgitation. The only treatment for PRAA is surgical correction. The sooner your dog has surgery to fix it, the higher his chances of a full recovery. If you postpone the surgery too long, his prognosis of a full recovery declines.

Persistent right aortic arch is a congenital condition that can affect your puppy. If not fixed, he may not be able to grow and thrive due to inability to swallow his food and absorb the nutrients. If your puppy is vomiting or regurgitating his food, take him to a veterinarian.


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Symptoms of Persistent Right Aortic Arch in Dogs

Symptoms of PRAA typically make themselves known when the dog begins to eat solid foods. Symptoms may include:

  • Inability to get food down
  • Regurgitation
  • Dilated/stretched esophagus
  • Stunted growth
  • Breathing problems


  • There is only one type of persistent right aortic arch that can occur in dogs
  • The severity can range from mild to moderate and even to severe
  • The severity of the issue will play a role in diagnosis, treatment, and recovery of this issue in your dog
  • Other names PRAA is known by include vascular compression of the esophagus or vascular ring anomaly

Causes of Persistent Right Aortic Arch in Dogs

PRAA in dogs is typically congenital, meaning the puppy was born with the condition. It is an abnormality of the blood vessels of the heart that can interfere with the function of the esophagus. If your dog has PRAA, it means an embryonic branch of the aorta wraps around the esophagus and puts pressure on the tube. This prevents the esophagus from being able to pass food and will cause him to regurgitate it.

Diagnosis of Persistent Right Aortic Arch in Dogs

As your puppy is growing and developing, symptoms of PRAA will make themselves apparent sooner rather than later. If you suspect your dog is having trouble eating, it is a good idea to take him to the veterinarian. 

When you arrive, she will begin by performing a complete physical exam to ensure there are not other things going on too. She will also verbally collect a history from you to discuss how long it has been occurring, if it has been getting progressively worse, or if he could have ingested something he wasn’t supposed to. This will give her an idea of possible causes of his symptoms.

One of the first things she will suggest is to perform blood work. This will allow her to check for any causes occurring from within, such as organ failure or parasite infection. A chemistry panel and complete blood count will give her the basic information she needs. She may also perform a packed cell volume (PCV) to check your dog’s hydration status. If he is regurgitating relatively frequently, dehydration is a concern.

The next diagnostic she will recommend is to have radiographs taken. This will allow her to check for multiple probable causes of his symptoms. She will take a radiograph of the abdomen to check for any gastrointestinal blockage. She will also take a radiograph of his chest and esophagus to check for a blockage or abnormality there. If your dog does have PRAA, his radiograph will show he has a dilated esophagus, also known as megaesophagus. In most cases, the dilation will run from the esophagus to the base of the heart. In certain cases, the veterinarian may want to use a contrast known as barium to emphasize the dilation.

Treatment of Persistent Right Aortic Arch in Dogs

The ultimate treatment to correct PRAA is surgery. During surgery, a constricting ring is placed around the abnormal vessel causing it to degenerate over a period of time. Other forms of treatment include allowing the esophagus to return to its normal size and function. In order to do this, the veterinarian may recommend small meals of wet or moistened food to allow the food to go down easily. When you are feeding your dog, try to feed him from above instead of in a bowl from below in order to let gravity pull the food into the stomach versus making the esophagus work. 

Given time, the embryonic branch of the aortic vessel will degenerate and therefore no longer put pressure on your dog’s esophagus. This will allow him to eat properly and begin to thrive.

Recovery of Persistent Right Aortic Arch in Dogs

Recovery of PRAA will depend on when you sought surgical correction for your dog. The earlier you seek veterinary care for him, the better his chances of a full recovery. Even if your dog does have surgery, there is not a guarantee it will solve the issue entirely. For example, if your dog suffered nerve damage or if his esophagus was severely distended before he received treatment, he may have long term issues.

Persistent Right Aortic Arch Questions and Advice from Veterinary Professionals

English Mastiff
10 Weeks
Serious condition
1 found helpful
Serious condition

Has Symptoms


Our sweet pup has been diagnosed with PRAA. We have gone over a lot of different options but we are still trying to find other possibilities or options we have not thought of. We have been informed that he might not be able to make it out of surgery due to his age. Also with his prognosis, even if he does make it out of surgery he is possibly looking at a lifetime of issues ahead of him. We have been pureeing his kibbles in a food processor with water and canned food and making it basically a liquid for him to "eat". He has not regurgitated in a couple of days and is finally gaining weight. He is the sweetest, happiest little guy and we just want him to be healthy. Initially his x-rays looked like a megaesophagus but after a barium swallow test we were informed by multiple doctors that it is PRAA. Are there other good options than surgery?? and if he does have surgery what are the odds of him 1) living through it and 2) 100% recovering without other health issues linked to his PRAA?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations
Surgery is the treatment of choice for cases of persistent right aortic arch, the main issue is that the vessel which is causing all the problems is not going to disappear on its own so when a pup is strong enough we correct the problem with surgery. If the surgery isn’t performed, Sullivan will require liquid feeding for the remainder of his life and will be at a higher risk of aspiration pneumonia. The two links below cover post surgery prognosis after transection of the vessel. Regards Dr Callum Turner DVM (see end of last page)

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10 Weeks
Moderate condition
0 found helpful
Moderate condition

Has Symptoms


I'm looking for recommendations on veterinarians who have successfully performed the corrective surgery for persistent right aortic Arch. We live in northern California. He is very happy and doesn't act sick at all. I went to the vet a few days ago because he vomited a few times I currently mush his food in to a paste texture and the symptoms have eased up. I'm extremely worried with him being so small he weights about 4 lbs.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3320 Recommendations
If you’re looking for a Veterinary Cardiologist your Veterinarian will be more familiar with local Specialists than myself, but you may use the link below to search a directory of Cardiologists closest to your zip code. Regards Dr Callum Turner DVM

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Border Collie
3 Months
Serious condition
0 found helpful
Serious condition

Has Symptoms

Regurgitation, aspiration pneumonia

I'm looking for some recommendations on experienced veterinary soft tissue surgeons who could operate successfully on my dog. My 3 months old male Border Collie mix puppy got diagnosed with megaesophagus (50% dilation of esophagus caudal to heart) secondary to PRAA from a Barium swallow study. He has gone from 6 lb to 11 lb after I started feeding him appropriately and he is energetic, smart, and otherwise healthy. I'm looking for surgeons with experience with PRAA and would like to get a list of veterinary surgeons who have experience with PRAA I could possibly schedule a consult with. His current vet recommends him to get this surgery in the next 1-2 months' time.

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for contacting us about Molar. Without knowing where you live, I can't give any recommendations for surgeons, but I would ask your veterinarian to give you a referral, or typically veterinary colleges have board certified specialty surgeons that are able to perform this surgery, or who will know other surgeons in the area capable of performing the surgery. I wish you luck in your search.

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