Figures
![Figure 1.](/tables/jmc1047w-g001.jpg)
Figure 1. Movie 1. A large PDA (with left to right shunt) was seen measuring 0.72 cm in diameter, compared to a descending aorta diameter of 0.69 cm. Suspected to be on the right side as there was a RAA.
![Figure 2.](/tables/jmc1047w-g002.jpg)
Figure 2. Movie 2. Echocardiographic sweep showing a suspected double aortic arch.
![Figure 3.](/tables/jmc1047w-g003.jpg)
Figure 3. Movie 3. 3D MRI angiogram reconstruction. The study was performed without general anesthetic knowing that some respiratory artifact would be acceptable. The first branch was a suspected BCT giving rise to the RCCA, LCCA, and LSCA, the second branch was the RSCA.
![Figure 4.](/tables/jmc1047w-g004.jpg)
Figure 4. Schematic of intra-operative anatomy showing shortness in length of PDA and relationship of proximity of LPA and LSCA, pre-transection (a), and post-transection (b).
![Figure 5.](/tables/jmc1047w-g005.jpg)
Figure 5. Movie 4. 3D MRI post-op: The suspected BCT was oriented anteriorly such that blood from the ascending aorta took a U-turn to perfuse it. Off the suspected BCT, the RCCA, LCCA and LSCA arose individually and the trunk’s distal end was patched.
![Figure 6.](/tables/jmc1047w-g006.jpg)
Figure 6. Movie 5. Echo study: forward flow from ascending aorta into large caliber persistent proximal left dorsal aorta then into head and neck vessels without obstruction or flow acceleration.
![Figure 7.](/tables/jmc1047w-g007.jpg)
Figure 7. Schematic of embryologic development of a normal LAA.
![Figure 8.](/tables/jmc1047w-g008.jpg)
Figure 8. The suspected BCT is actually a large segment of a persistent proximal left dorsal aorta (LDA) (a) making this an incomplete double aortic arch with involution of the distal portion of the left dorsal aorta (b).