The combination of a left aortic arch, a right-sided descending thoracic aorta with a left-sided arterial duct

A nine-year-old male child presented with a history of recurrent chest infections and breathlessness. On investigation, he was found to have a left aortic arch with a right-sided descending thoracic aorta along with a left-sided arterial duct. He also had mild aortic stenosis with regurgitation. The duct was successfully ligated under controlled hypotensive anesthesia through a left posterolateral thoracotomy.