Right aortic arch with a unique branching pattern, coarctation of the aorta, and vascular ring: a management conundrum

The combination of a right aortic arch with a vascular ring and coarctation of the aorta is a rare association, presenting a unique management challenge for the primary team. A thorough literature review revealed only seven published case reports, with three cases reported in the neonatal period with similar anatomy. This distinctive anatomy inspires inquiry into the development of coarctation in the context of a right aortic arch and vascular ring, as well as the best approach to surgical management. We encountered a similar case in a neonate with a combination of these malformations and a unique aortic arch branching pattern. Cardiac CT was instrumental in the diagnosis and surgical planning. This article reviews the variations in anatomy, clinical presentation, imaging findings, and management challenges encountered in the reported cases. This comprehensive review aims to assist the primary team in making informed decisions when treating these complex patients.