Congenital Absence of Bilateral Common Carotid Arteries

Congenital bilateral absence of the internal carotid arteries (CA) is a rare vascular abnormality, in which cerebral perfusion is maintained solely by the vertebral arteries [1]. Congenital absence of the common CA has not been described, to our knowledge. A full-term infant received a diagnosis of aortic valve atresia, severely hypoplastic (1.5 mm) ascending aorta (AAo), a large perimembranous ventricular septal defect, and a large ductus on echocardiogram. Magnetic resonance imaging obtained to assess the arch anatomy showed an interrupted aortic arch and aortic atresia without visualization of the AAo or the transverse aortic arch (Fig 1; MPA main pulmonary artery). The left subclavian artery (LSA) arose from the proximal descending aorta (dsAo), where the left-sided arterial duct (LAD) was connected and gave rise to the left vertebral artery (LVA). The right-sided arterial duct (RAD) arose from the right pulmonary artery and