Left aortic arch with right descending aorta and right ligamentum arteriosum associated with d-TGA and large VSD: surgical treatment of a rare form of vascular ring.

A 1-month-old boy with respiratory distress underwent pulmonary artery banding after diagnosis of d-loop transposition of the great arteries and ventricular septal defect. Respiratory distress recurred after surgery. Angiography, esophagography, and magnetic resonance imaging showed left aortic arch, retroesophageal aorta, and right descending aorta. Surgery at 9 months of age showed a right-sided ligamentum arteriosum. Division of the ligamentum relieved the constriction of the esophagus and trachea caused by this rare form of vascular ring.