Objective:

To provide insights into the prenatal recognition, postnatal management, and clinical decision-making for persistent fifth aortic arch (PFAA) with coarctation and fourth aortic arch interruption, highlighting their significance in improving diagnostic accuracy and patient outcomes.

Key Findings:

• PFAA with fourth aortic arch interruption is a rare congenital anomaly with significant clinical implications.
• Prenatal diagnosis is challenging due to the absence of significant hemodynamic changes, necessitating improved training for sonographers.
• Postnatal closure of the ductus arteriosus can lead to rapid narrowing and heart failure, underscoring the importance of timely intervention.

Interpretation:

The case highlights the difficulties in prenatal diagnosis and the importance of timely surgical intervention for PFAA, suggesting a need for enhanced training and awareness among healthcare providers.

Limitations:

• Limited awareness among sonographers may contribute to low prenatal detection rates, impacting early diagnosis and treatment.
• Current literature primarily consists of case reports or small series, indicating a need for larger studies to better understand this anomaly.

Conclusion:

This case provides valuable insights for the diagnosis and management of a rare aortic arch anomaly, suggesting avenues for future research to improve detection and outcomes.