An unusual neonatal case of reverse flow in the aortic arch and persistent pulmonary hypertension

The reverse flow in the aortic arch in newborn is a rare finding due to congenital heart disease with blood "stealing" from the descending aorta or severe left ventricular outflow tract obstruction and to extracardiac abnormalities as systemic arteriovenous malformation. We describe a female newborn with unexpected reverse flow in the aortic arch due to severe persistent pulmonary hypertension (PPH). The presence of reverse flow in the aortic arch in PPH, secondary to compromised LV output, was rarely reported and investigated but can be a helpful sign of worse clinical course and poor prognosis.