Ventriculo-peritoneal shunt surgery in an infant with double aortic arch, patent ductus arteriosus and atrial septal defect.

Double aortic arch with patent ductus arteriosus and atrial septal defect is an uncommon association. Such complex cardiac lesions may complicate an otherwise normal anesthetic course. We came across a case with aqueductal stenosis and hydrocephalus, scheduled for ventriculo-peritoneal shunt surgery, on an emergent basis. The child was managed successfully. The anesthetic implications of resultant left-to-right shunt with increased intracranial pressure have been described.