The surgical repair of a tracheoesophageal fistula combined with the double aortic arch

A newborn with a vascular ring exhibiting a right-dominant double aortic arch (DAA), a left-side patent ductus arteriosus (PDA), and esophageal atresia with a tracheoesophageal fistula (TEF), was admitted to our neonatal intensive care unit. Although very rare, TEF and DAA may co-occur early in development. We recommend that, first, the fistula should be repaired and the esophageal anastomosis should be performed after division of the DAA. When an AA abnormality (including a DAA) is evident, the approach to the AA and the direction of the thoracotomy incision should be reversed to render surgery relatively easy.