Concurrence of double aortic arch in tetralogy of Fallot with absent pulmonary valve syndrome

Tetralogy of Fallot with absent pulmonary valve syndrome (ToF-APVS) is a congenital heart disease with dilated pulmonary arteries causing varied degrees of bronchial compression. Double aortic arch is a complete vascular ring encasing the trachea and oesophagus causing early respiratory compromise. This unique case highlights the concurrence of double aortic arch in ToF-APVS causing respiratory compromise at the tracheal and bronchial levels detected on computed tomography angiography. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-025-02036-0.