Pseudocoarctation of the aorta

Pseudocoarctation of the aorta is a very rare anomaly characterised by kinking or buckling of the descending aorta at the level of the ligamentum arteriosum without a pressure gradient across the lesion.

It is thought to be of congenital origin, and characterised by elongation and kinking of the aorta at the level of the ligamentum arteriosum.

Its exact aetiology not well known. One proposed embryologic cause is a failure of compression of the third through the seventh segments of the dorsal aortic roots and the fourth arch segment.

Associations

Rarely reported associations include 3:

CT angiography

The following features have been shown to be useful in diagnosis (according to case reports) 3:

  • demonstration that the abnormal mass in the mediastinum is part of the aorta
  • unusually aortic arch high in the mediastinum
  • visualisation of the isthmic portion of the descending thoracic aorta that's not adjacent to the spine, but rather ventral to it - this is surrounded by aerated lung
  • a more caudal origin of the subclavian artery

Other reported features include 2:

  • the aortic arch of pseudocoarctation is elongated and may arise higher than the clavicle (associated with cervical aortic arch)
  • absence or only a mild degree of stenosis of the aortic lumen
  • the absence of collateral circulation
  • the absence of left ventricular hypertrophy and ascending aortic dilation

Cardiac catheterization and angiography provide a definitive diagnosis.

It is considered a benign entity with no specific intervention 8. Some advocate surgical treatment for all symptomatic patients and those with associated aneurysm formation 7.

It is thought to have been first described by Dotter, Steinberg, Souders and co-workers in 1951 3,5.

Consider the true coarctation of the aorta

  • evidence of collateral circulation (e.g rib notching)
Share article

Article information

rID: 26380
Systems: Cardiac, Vascular
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Aortic pseudocoarctation
  • Aortic pseudo-coarctation
  • Pseudo-coarctation of the aorta
  • Pseudocoarctation of aorta
  • Buckling of the aorta
  • Kinking of the aorta
  • Kinking of aorta
  • Buckling of aorta
  • Pseudo-coarctation of aorta

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.