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Interrupted aortic arch

Case contributed by Fazel Rahman Faizi
Diagnosis certain

Presentation

Cyanosis and respiratory distress.

Patient Data

Age: 1-year-old
Gender: Male
ct

There is discontinuity of the aortic arch distal to the origin of the left common carotid artery. 

The descending aorta originates from the main pulmonary artery via a large patent ductus arteriosus. The left subclavian artery originates from descending aorta.

The main, right and left pulmonary arteries are dilated without thrombus formation. The pulmonary arteries are engorged relative to their accompanying bronchi, which likely relate to arterial hypertension.

A large ventricular septal defect is demonstrated. 

The heart is enlarged predominantly on the right side. 

Pulmonary veins are draining into the left atrium from either side. 

Left-sided persistent superior vena can is seen draining into the coronary sinus. 

Right superior vena cava and inferior vena cava are draining into the right atrium. 

Air space consolidation is noted in the posterior segment of the right upper lobe.

Case Discussion

Imaging findings are consistent with type B interrupted aortic arch. Interrupted aortic arch (IAA) is characterized as total luminal discontinuity between the ascending and descending aorta. Multislice CT angiography is considered as a suitable imaging modality complementary to echocardiography for the diagnosis and preoperative evaluation of the IAA and its associated anomalies.

 

Dr. Farhad Farzam has also contributed to this case.

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