Selective cyanosis of the right arm. Isolation of right subclavian artery from aorta with bilateral ductus arteriosus and pulmonary hypertension

A sixteen-month-old child presented with cyanosis of the right arm. Investigation revealed bilateral persistent ductus arteriosus with isolation of the right subclavian artery from the aorta. Pulmonary vascular resistance and pulmonary arterial pressure were elevated so that the right subclavian artery received desaturated blood from the right pulmonary artery via the persistent right ductus arteriosus.