Left-Sided Patent Ductus Arteriosus and Right-Sided Aortic Arch

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Abstract
Angiocardiography in 3 female patients, aged 8 months, 3 1/2 years, and 6 years, respectively, established patency of a left-sided ductus arteriosus and a right-sided aortic arch. All had congenital cyanotic heart disease and atresia of the main pulmonary artery. Two cases fitted into the category of the pseudotruncus arteriosus type of tetralogy of Fallot in that there was atresia of the main pulmonary artery, enlargement of the right ventricle, a right-to-left shunt at the ventricular level, and immediate opacification of a dilated ascending aorta. The other patient had the classic features of tricuspid atresia with a right-to-left shunt at the atrial level, hypoplasia of the right ventricle, and an enlarged left ventricle which opacified a large ascending aorta. In every instance the ductus arose from an inferior branch of the left subclavian artery and opacified both pulmonary arteries. The left subclavian and left common carotid arteries came off from a left innominate artery which was the first branch of the right-sided aorta. Since an artifical aortico-pulmonary shunt is often indicated for relief of cyanotic congenital heart disease, demonstration of a persistent ductus arteriosus is important and precludes surgery for the creation of an aortico-pulmonary shunt.