A Rare Complete Vascular Ring: Right Aortic Arch, Large Left Sided Patent Ductus Arteriosus, and Isolated Left Subclavian and Vertebral Arteries Mimicking a Double Aortic Arch.

Abstract

We present the case of a symptomatic 6 month old infant with a very rare form of complete vascular ring caused by a right aortic arch with abnormal branching pattern and a large left-sided patent ductus arteriosus (PDA). The large left sided PDA connected between the main pulmonary artery and the descending thoracic aorta. This configuration in combination with the right aortic arch caused tracheoesophageal compression. In addition, the left subclavian artery (LSA) and left vertebral artery (LVA) were originating from the PDA (Isolated left subclavian and left vertebral artery). This anomaly closely parallels the characteristics observed in a double aortic arch. Successful management was achieved by division of the PDA with re-implantation of the isolated LSA and LVA into the left common carotid artery.