Persistent Fifth Aortic Arch With Left Ventricular Dysfunction and Left Bronchial Obstruction.

Persistent fifth aortic arch (AA) is a rare anomaly in congenital heart disease, which is often associated with aortic obstructive diseases. We report a 7-month-old infant diagnosed with persistent fifth AA with left ventricular dysfunction along with left bronchial malacia due to compression from their own heart. Surgical repair was performed, including AA reconstruction using the fifth AA as an in situ flap to enlarge the fourth AA with end-to-end anastomosis, and external stenting for the left bronchial malacia. Postoperative courses were uneventful. On computed tomography, a reconstructed AA without obstruction and an expanded left bronchus were seen.