Rare Combination of Right Aortic Arch, Aberrant Left Subclavian Artery and Absent Left Pulmonary Artery in a Boy with Tetralogy of Fallot

Abstract

Introduction

Right aortic arch is associated with an aberrant subclavian artery and absence of left pulmonary artery in patients with Tetralogy of Fallot. However, the occurrence of a combination of the right aortic arch, an aberrant left subclavian artery, and an absent left pulmonary artery in a single patient is rare. Therefore, the purpose of this case report was to discuss the rare association between a right aortic arch, the absence of a left pulmonary artery, and an aberrant left subclavian artery in an 8-year-old Ethiopian boy with Tetralogy of Fallot.

Case Presentation

An 8-year-old male child who presented with easy fatigability, dizziness, and intermittent difficulty in swallowing solid food over the past two years. He had grade clubbing, cyanosis of the lips, and an ejection systolic murmur at the left lower sternal border. Tetralogy of Fallot with absent left pulmonary and right aortic lesions was diagnosed using echocardiography. CT tomography revealed a detailed vascular anatomy and confirmed the diagnosis of an aberrant left subclavian artery.

Conclusion

In the evaluation of patients with Tetralogy of Fallot, it is important to pay close attention to vascular abnormalities such as right aortic arch, aberrant left subclavian artery, and absent left pulmonary artery for not missing them.

Keywords:

• Tetralogy of Fallot
• right aortic arch
• aberrant left subclavian artery
• absent left pulmonary artery

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethical Clearance

Ethical clearance was obtained from Saint Paul’s Hospital Millennium Medical College Research Ethics Review Board, Addis Ababa, Ethiopia.

Consent

Verbal informed consent was obtained from both parents and the child to use their patients’ medical information and images for publication. The consent was verified by a research ethics review board.

Acknowledgment

We would like to acknowledge the patient for providing us consent to share his history as a case report and Cardiac Centre of Ethiopia and Saint Paul’s hospital millennium medical college for evaluating the case and giving us ethical clearance.

Disclosure

The authors declare no conflicts of interest in this work.

Additional information

Funding

No specific grants were obtained for this case report from any funding agency.