The First Reported Case of Right Aortic Arch with Left Subclavian Artery Atresia Presenting with Heart Failure with Reduced Ejection Fraction: Exploring an Uncertain Causal Relationship

The largest artery in the body is the aorta. The ascending aorta, aortic arch, thoracic aorta, and abdominal aorta are the four sections that make up the aorta. The ascending aorta continues into the aortic arch. It moves inferiorly after arching superiorly, posteriorly, and to the left [1]. The right aortic arch is a rare anatomical anomaly of the aorta [2]. A case of a 43-year-old male was recently diagnosed with heart failure with reduced ejection fraction (HFrEF). Cardiac CT was performed as part of the ischemic heart disease evaluation. The cardiac CT revealed a right-sided aortic arch, along with the absence of the proximal segment of the left subclavian artery, and the perfusion of the left subclavian artery occurring via the left vertebral artery. This case represents the first documented instance in the literature of heart failure occurring concurrently with these vascular anomalies.