Management of vascular ring is always a matter of great concern. There is limited literature on management of carbon dioxide retention in mechanically ventilated patients with vascular rings due to double aortic arch, while awaiting corrective cardiac surgery. A 29-day-old girl with complete duplicated double aortic arch, left descending aorta, and a left patent ductus arteriosus, had severe upper respiratory tract obstruction with carbon dioxide retention. She was managed successfully by endotracheal tube manipulation.
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