Shuxuan QIN, Lin HE, Wan LI, Cong LIU, Yuman LI
The Anatolian Journal of Cardiology - 2026;30(7):0-0
A 13-year-old female patient presented with a 2 month history of precordial bulge, without cyanosis, syncope, developmental delay, or family history of genetic disorders. Echocardiography showed right ventricular outflow tract obstruction, severe pulmonary stenosis, a ventricular septal defect, and overriding of the aorta, confirming the diagnosis of tetralogy of Fallot (TOF). In addition, echocardiography revealed a right-sided aortic arch (RAA) and an anomalous vascular structure connecting to the main pulmonary artery (MPA). Color Doppler imaging demonstrated continuous blood flow within this vessel. Further computed tomography angiography with 3D reconstruction revealed the RAA and anomalous origin of the left common carotid artery (LCCA) from the MPA, with proximal segment tortuosity. Consequently, a comprehensive cerebral evaluation was conducted for the patient, and time-of-flight magnetic resonance angiography of the brain showed well-developed intracranial segments of the bilateral vertebral arteries, basilar artery, and right posterior communicating artery. Subsequently, the patient underwent TOF corrective surgery with concomitant ligation of the aberrant LCCA. The patient's oxygen saturation increased from 92% preoperatively to 100% postoperatively, and the patient was discharged 20 days after surgery and showed good recovery at the 6-month follow-up.
