Diagnosis of Anomalous Origin of the Right Subclavian Artery from the
Right Pulmonary Artery in a Patient with D-transposition of the Great
Arteries Utilizing Transthoracic Echocardiography
Abstract
Diagnosis of anomalous origin of the right subclavian artery (AORSA)
from the right pulmonary artery (RPA) is usually made using CT or
invasive angiography. We report a patient diagnosed using transthoracic
echocardiography (TTE). A newborn girl prenatally known to have d-TGA
presented with cyanosis sparing the right hemithorax and arm. Oxygen
saturations on the right hand were persistently higher than on the right
ear and other extremities. Repeat TTE using a modified echocardiographic
imaging plane allowed for full visualization of the entire subclavian
artery course, revealing AORSA from RPA. We discuss further the approach
to echocardiographic diagnosis and surgical implications.