We report a case of a 750 grams premature female who was scheduled for surgical ligation of a patent arterial duct. Intra-operative findings showed a patent arterial duct in association to a retro-esophageal aortic arch creating a complete vascular ring around the trachea. which was successfully divided. A vascular ring should be ruled-out in premature infants prior to ductal ligation... https://www.chiggate.com/elliot-pecan-tree-sale/