Aortic atresia with the interrupted aortic arch and an pulmonary-coronary fistula: the unique constellation for survival.

Aortic atresia with interrupted aortic arch is a rare anatomical and physiological combination. Survival is possible if there is blood flow in the ascending aorta supplying the coronary circulation from coexisting malformations. We present a newborn with aortic atresia, interrupted aortic arch type B, ventricular septal defect and a pulmonary artery to left coronary artery fistula as a source of blood flow to the coronary circulation, ascending aorta and proximal aortic arch, successfully treated with neonatal biventricular repair. To our knowledge, this is the first patient described in the literature with coronary blood flow dependent on a pulmonary-coronary arterial fistula.