Isolation of Left Subclavian Artery with Tetralogy of Fallot—A Case Report

Background: Isolation of Left Subclavian Artery (LSCA) is a rare subset of Right Aortic Arch (RAA). It is diagnosed as nonvisualization of LSCA in catheterization study. Case Presentation: Here we report an unusual case of Tetralogy of Fallot (TOF) with right aortic arch with isolation of left subclavian artery (LSCA). Here LSCA originated from left pulmonary artery (LPA) through an atretic patent ductus arteriosus (PDA). There was nonvisualization of LSCA in catheterization study and it was confirmed by Computed Tomography (CT) angiography. Re-implantation of LSCA was done to left common carotid artery (LCCA) so that the left upper arm maintains a better flow in the future. Conclusion: Isolation of LSCA especially with TOF is a very rare entity. Re-implantation of LSCA to LCCA was done in view of weak pulses in left upper limb. Results were satisfactory in the follow up period.

[1]  S. Sethi,et al.  Right aortic arch with isolation of the left innominate artery in a case of double chamber right ventricle and ventricular septal defect , 2014, Annals of pediatric cardiology.

[2]  I. Zabala,et al.  Right aortic arch with isolation of the left innominate artery arising from the pulmonary artery and atrial septal defect. , 2011, The Annals of thoracic surgery.

[3]  F. Pigula,et al.  Neonatal Closure of a Large Coronary‐Cameral Fistula in a Case of Single Coronary Artery: The Utility of Intraoperative Angiography , 2010, Journal of cardiac surgery.

[4]  C. McMahon,et al.  Subclavian Steal Syndrome in Anomalous Connection of the Left Subclavian Artery to the Pulmonary Artery in D-Transposition of the Great Arteries , 2001, Pediatric Cardiology.

[5]  R. Grifka,et al.  Right aortic arch with isolation of the left subclavian artery, moderate patent ductus arteriosus, and subclavian steal syndrome: A rare aortic arch anomaly treated with the Gianturco‐Grifka vascular occlusion device , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[6]  P. Luetmer,et al.  Right aortic arch with isolation of the left subclavian artery: case report and review of the literature. , 1990, Mayo Clinic proceedings.

[7]  K. Amplatz,et al.  Isolation of a subclavian artery. , 1981, AJR. American journal of roentgenology.

[8]  W. Schey.  Right aortic arch: Plain film diagnosis and significance , 1966 .

[9]  J. Edwards,et al.  Anomalies of the derivatives of the aortic arch system. , 1948, The Medical clinics of North America.