“…It is imperative to note that both the pulmonary arteries and the ductus arteriosus are embryologically derived from the left sixth aortic arch which might explain the coexistence of variant pulmonary arterial anatomy and persistent ductus arteriosus, as seen in our case (4). The left vertebral artery was seen arising from the left common carotid artery, which is extremely uncommon and when there is anomalous origin of the left vertebral artery, it usually arises directly from the aortic arch (5). Accessory non-azygous fissure of the right upper lobe is also very rare, and is mentioned in case reports.…”