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Out of 832 congenital heart diseases (CHD) referred to a tertiary center, 98 cases had RAA. Based on anatomical landmarks we identified 7 types of AD: <jats:italic>type 1<\/jats:italic> left-sided, transverse; <jats:italic>type 2<\/jats:italic> left-sided, vertical; <jats:italic>type 3<\/jats:italic> from the underside of aortic arch (AA), vertical; <jats:italic>type 4<\/jats:italic> right-sided, mirror-image \u201cV\u201d, transverse; <jats:italic>type 5<\/jats:italic> right-sided, \u201cH\u201d shaped, transverse; <jats:italic>type 6<\/jats:italic> bilateral; <jats:italic>type 7<\/jats:italic> absent or unidentifiable. For each type of AD the incidence of associated major CHD was calculated and chi-square test was applied to verify the null hypothesis with significance level of p\u2009&lt;\u20090.05. Type 1 occurred in 43% of cases including 4 with CHD and no cases with pulmonary outflow obstruction (POO). Symptoms of vascular ring were present in 41% of survivors. Type 2, 3 and 7 AD were associated with tetralogy of Fallot (TOF) or equivalents. No type 5 AD with CHD had POO and 3 isolated cases had asymptomatic hypoplasia of left pulmonary artery (LPA). Two type 6 AD had disconnection of LPA. Type 1 occurred more often as an isolated finding (p\u2009&lt;\u20090.001), whereas types 2 (p\u2009=\u20090.0026), 3 (p\u2009=\u20090.0045), 4 (p\u2009=\u20090.0325) and 7 (p\u2009=\u20090.0001) were frequently associated with major CHD. In RAA, type 1 (U-shaped) is usually an isolated finding (p\u2009&lt;\u20090.001) which includes all symptomatic vascular rings. POO is always present when the AD is vertical or absent but not when it lies on a transverse plane. Bilateral AD is rare and brings the risk of functionary loss of left lung if not identified.<\/jats:p>","DOI":"10.1007\/s10554-021-02325-w","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T11:05:41Z","timestamp":1625742341000},"page":"3385-3395","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The multiform sonographic spectrum of arterial duct in right aortic arch"],"prefix":"10.1007","volume":"37","author":[{"given":"Enrico","family":"Chiappa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Ridolfi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2206-8909","authenticated-orcid":false,"given":"Adalgisa","family":"Cordisco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2325_CR1","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/B978-0-7020-3064-2.00045-X","volume-title":"Paediatric cardiology","author":"LN Benson","year":"2010","unstructured":"Benson LN (2010) The arterial duct: its persistence and its patency. 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