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Radiological Case of the Month

Stanley Einzig, MD, PhD; Robert Steelman, MD; Lee A. Pyles, MD; Arpy Balian, MD; Eric Millman, MD
Arch Pediatr Adolesc Med. 1997;151(12):1259-1260. doi:10.1001/archpedi.1997.02170490085016.
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A 7-MONTH-OLD boy was admitted to the hospital with respiratory distress secondary to upper airway obstruction. The patient had previously been diagnosed with VATER complex in the neonatal period. Associated anomalies included agenesis of the left kidney, hypoplastic left thumb, cystic right kidney, and a tracheoesophageal fistula, which was repaired. The patient had also undergone a pyloromyotomy for pyloric stenosis and a Nissen fundoplication for gastroesophageal reflux.

Findings from a clinical examination of the heart were normal. Cardiac ultrasonographic examination showed normal cardiac anatomy, normal myocardial contractility, no patent ductus arteriosus, or coarctation of the aorta. Color-flow Doppler (Figure 1) and 2-dimensional echocardiograms (Figure 2) were obtained.

Denouement and Discussion 

Persistent Left Fifth Aortic Arch in a Child Without Congenital Heart Disease  Persistence of the left fifth aortic arch is rare. The first case was reported by Van Praagh and Van Praagh,1 and since 1969, 16 additional cases


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