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From a developmental point of view, the abnormal connections between great arteries might be related to a deficient lengthening of the outflow tract during development. They are an important causal factor for cyanotic heart disease. This paper presents a report of a rare arterio-venous cardiac malformation case in which the ascending aorta was fused with the trunk of the pulmonary artery. Even though the perfusion related morbidity is undeniable in this case, the exact cause leading to mortality remains uniquely dubious. Exactly how the subject reported here escaped diagnoses and managed to survive until late adulthood remains a biological wonder. Such variations hold implications for cardiothoracic surgeons and clinicians dealing with cyanotic and circulatory disorders.
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