Successful treatment of patent ductus arteriosus accompanying right-sided aortic arch and aberrant left subclavian artery: a case report

Abstract

Background The coexistence of right-sided aortic arch (RAA), an aberrant left subclavian artery (ALSA) and a patent ductus arteriosus (PDA) is a rarely seen vascular ring anomaly. There is currently no general guideline consensus on management and follow-up of this congenital defect, posing a challenge to the clinicians. At this point, the heart team plays a critical role in the management of the disease. Case Report In the present case, a 25-year-old male patient was presented to outpatient clinic with dyspnea and fatigue. A transthoracic echocardiography revealed PDA with a left-to-right shunt. To evaluate the anatomy thoroughly a thoracic computed tomographic angiography was performed and showed PDA accompanying ALSA and RAA. The patient was evaluated by Heart Team and a percutaneous closure of PDA was recommended due to signs of left ventricular volume overload. Closure was performed with Amplatzer Vascular Plug II (AVP II) successfully. At follow up, the patient was free of symptoms. Conclusion Clinicians should be aware of the potential concomitant lesions during the diagnostic work-up. In selected patients, percutaneous closure of PDA may be the first-line therapy in experienced centers.