DOI: 10.36347/sasjm.2023.v09i06.032

Pages: 716-719

We describe a rare combination of aortic arch variant anatomy, seen on trans-thoracic echocardiogram and cardiac CT during the course of investigations for a suspected aortic dissection in a 20-year-old patient with a history of infective endocarditis. This combination included a truncus bicaroticus, an aberrant right subclavian artery, an aortic coarctation, and a bicuspid aortic valve. This patient also presented a rare complication of infective endocarditis namely a pseudoaneurysm of the Valsalva sinus and some abdominal aortic branch variations. These included a right hepatic artery emanating from the superior mesenteric artery, and a left gastric artery emerging directly from the abdominal aorta adjacent to the coeliac trunk. In isolation, these anomalies have been reported with different frequencies, but as far as we know, this particular combination has rarely been reported. We provide an imagistic portrayal of these anomalies on Tran’s thoracic echocardiogram and cardiac CT.