Introduction
Anomalous origin of the right subclavian artery (AORSA) from the right
pulmonary artery (RPA) is extremely rare in dextro-transposition of the
great arteries (d-TGA). Only a few cases have been
reported.1-6 Diagnosis is usually incidentally made
using Computed Tomography (CT) or invasive angiography. We report a
patient that was interestingly suspected based on clinical presentation
and subsequently diagnosed with transthoracic echocardiography (TTE).
This case demonstrates the importance of considering aortic arch
anomalies in d-TGA when patients do not show reverse differential
cyanosis. We also discuss the clinical significance, embryology,
approach to echocardiographic diagnosis, and surgical implications.