Aortic coarctation with thrombosis

Case contributed by Dr Hidayatullah Hamidi

Presentation

Not presented

Patient Data

Age: 15 years
Gender: Male

Focal stenosis of the aorta just distal to the origin of the left subclavian artery (7 mm luminal diameter).

The prestenotic segment of the aortic arch measures 17 mm in diameter and the post stenotic segment measures 18 mm in diameter.

Central filling defect just distal to stenotic point (15 x 10 mm) suggesting thrombosis.

Multiple prominent collateral pathways are seen: dilated bilateral internal mammary arteries, dilated intercostal arteries, prespinal and paraspinal arteries, and superior epigastric arteries.

Direct origin of left vertebral artery from the aortic arch proximal to the origin of the left subclavian artery.

The left atrium and left ventricle are dilated with significant muscular hypertrophy of the left ventricular.

Normal appearance of the right heart, pulmonary trunk, and right and left pulmonary arteries.

No PDA.

SVC and IVC are normally draining to the right atrium.

Left persistent SVC is noted draining to the coronary sinus.

Pulmonary veins are normally draining to the left atrium.

Case Discussion

Post ductal aortic coarctation (adult type) with post stenotic thrombosis is presented in the case with marked collateral formation.

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