Tetralogy of Fallot with double aortic arch: a rare association

Abstract

A 2-year-old male child presented to us with a history of a single cyanotic spell at 3 months of age and episodes of squatting for the past 6 months. There were compression symptoms in the form of dysphagia, recurrent regurgitation, and cough. A routine chest roentgenogram showed a right ventricular apex and pulmonary oligemia. On echocardiography, a large subaortic ventricular septal defect was found with aortic override. There was severe infundibular and valvular pulmonic stenosis. The branch pulmonary arteries seemed confluent and adequately sized. Cardiac computed tomography angiogram revealed a codominant double aortic arch with tetralogy of Fallot (Figs. 2 and 3). Invasive angiography was done which revealed a double aortic arch, overriding aorta, confluent and adequate sized branch pulmonary arteries (Fig. 1) and normal coronary pattern. The patient underwent total correction with ligation of the left aortic arch.