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Rare arch and supra-aortic vessel anomaly

A 3-year-old child with history of a large secundum atrial septal defect came to our institution for surgical cardiovascular evaluation. The patient had reached all developmental milestones and was completely asymptomatic. During imaging workup, a three-dimensional magnetic resonance angiography (MRA) reconstruction showed an incidental finding of a unique left aortic arch with branch vessel anomalies. The images showed a fenestrated origin of the left common carotid artery (figure 1A) along with an independent origin of the right internal and external carotid arteries from the brachiocephalic trunk, with a partial …