Pediatric Cardiology

, Volume 31, Issue 2, pp 280–282 | Cite as

Tetralogy of Fallot with Persistent Fifth Aortic Arch: Echocardiographic Diagnosis

  • Gerard HolmesEmail author
  • Joanna L. Holmes
  • William BermanJr.
  • Steven Yabek
Case Report


Although persistent, fifth aortic arch (P5A) is an uncommon anomaly. Its incidence is unknown due largely to failure of recognition. Fundamental to its diagnosis is an adequate understanding of the various settings in which P5A may manifest. One of the more frequently reported manifestations of this unusual anomaly is a systemic-to-pulmonary connection in the presence of pulmonary atresia, with or without a ventriculoseptal defect. This report describes a new case of P5A in an infant with tetralogy of Fallot but not pulmonary atresia, which was diagnosed echocardiographically. The echo-Doppler characteristics of P5A in the presence of right ventricular outflow obstruction are described, and the implications regarding surgery for the accompanying defects are discussed. To the authors’ best knowledge, the described case is the first reported instance of P5A in this specific setting.


Echocardiography Persistent 5th aortic arch Tetralogy of fallot 

Supplementary material

Supplementary material 1 (AVI 1323 kb)

Supplementary material 2 (AVI 983 kb)

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Supplementary material 3 (BMP 484 kb)


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Gerard Holmes
    • 1
    Email author
  • Joanna L. Holmes
    • 1
  • William BermanJr.
    • 1
  • Steven Yabek
    • 1
  1. 1.Pediatrix Cardiology Associates of New MexicoAlbuquerqueUSA

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