Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 4, Number 5, May 2013, pages 333-339

Incomplete Double Aortic Arch and Window Patent Ductus Arteriosus in a CHARGE Syndrome Patient: A Case Report and Review of Literature

Figures

Figure 1.
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.
Figure 2. Movie 2. Echocardiographic sweep showing a suspected double aortic arch.
Figure 3.
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.
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.
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.
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.
Figure 7. Schematic of embryologic development of a normal LAA.
Figure 8.
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).