Breaking the Rules: Left Common Carotid Artery from the Main Pulmonary Artery in an Infant with a Vascular Ring

Graphical abstract
Highlights Anomalous left common carotid artery is a unique and rare abnormality. Most aortic arch anomalies can be explained by the totipotential aortic arch. Rare anomalies may not fit traditional arch regression models. Echocardiography is key for arch anomaly diagnosis and monitoring. Identification of this very rare anomaly carries significant clinical implications.