Double aortic arch associated with coarctation, ventricular septal defect and right ventricular outflow tract obstruction: Successful surgical repair

A case of complex congenital heart disease is presented with an unusual combination of extracardiac and intracardiac anomalies. Preoperative catheterization and angiographic studies demonstrated infundibular pulmonic stenosis, ventricular septal defect and coarctation of the aorta. A double aortic arch was subsequently detected during operation. Total repair necessitated staging of the surgical procedure. The coarctation was bypassed by interposing a synthetic graft between the anterior and posterior aortic arches. The second stage consisted of direct vision intracardiac correction of the pulmonic obstruction and the ventricular septal defect.