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Left-sided aortic arch with normal branching is noted. There is abrupt segmental stenosis of descending aorta distal to the origin of the left subclavian artery. It measures 3 mm in diameter in its narrowest part. There is post-stenotic dilatation of the descending aorta. Aorta proximal to the stenosis measures 8mm in diameter whereas the aorta distal to the stenosis measures 15 mm in diameter. The internal mammary arteries are prominent. The pulmonary trunk is dilated measuring approximately 18 mm in diameter. The ascending aorta at this level measures 13 mm. Left heart chambers are slightly dilated. Early reflux of contrast into the IVC and hepatic veins is also noted.
The features are consistent with post-ductal type aortic coarctation. CTA/MRA/DSA can all be used for evaluation of the aortic coarctation and collateral branches.
Dr. Mohammed Tarhir Aien has also contributed to this case.