A natural systemic to pulmonary artery shunt

Indian J Thorac Cardiovasc Surg. 2023 Mar;39(2):201-203. doi: 10.1007/s12055-022-01423-1. Epub 2022 Oct 29.

Abstract

Isolation of the left subclavian artery is a rare anomaly associated with right aortic arch. We report a case in which this subclavian artery was supplying the pulmonary circulation in a patient with tetralogy of Fallot (TOF) which effectively acted as a natural systemic to pulmonary artery shunt. The patient had good room air saturation and no features of vertebrobasilar insufficiency or left upper limb ischemia. She underwent a total correction of TOF and ligation of the aberrant left subclavian artery.

Keywords: Aberrant subclavian artery; Subclavian steal phenomenon; Tetralogy of Fallot; Vertebrobasilar insufficiency.