Interrupted aortic arch (type A)

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Weakness and fatigue with hypertension. Chest X-ray revealed mild cardiomegaly with left ventricular enlargement.

Patient Data

Age: 18 years
Gender: Female
Modality: CT
  • Situs solitus with cardiac apex to the left. Atrio-ventricular concordance and ventriculo-arterial concordance.

  • Cardiomegaly is noted.

  • Intact interatrial septum (IAS) and interventricular septum (IVS).

  • The aortic arch is normal-sized and left sided. It gives three orderly branches. Normal origin, course and distribution of the coronary arteries. 

  • A short focal 0.4 cm interrupted aortic segment is seen just distal to the origin of the left subclavian artery.
  • Dilated parapspinal and intercostal collaterals are seen as well as hypertropied internal mammry arteries.
  • A small patent ducus arteriosus (PDA) is seen just distal to the left SCA and proximal to the interrupted aortic segment.
  • Confluent main pulmonary artery and its branches.
  • Prominent pulmonary veins. No evident anomalous pulmonary venous drainage.
  • Normal course of the innominate veins, right SVC and the visualized segment of the IVC.
  • Clear both lungs.
  • No pleural or pericardial collection. 

Case Discussion

Type A interrupted aortic arch (IAA) with a small PDA.

Interruption of the aortic arch (IAA) is a discontinuity of the ascending and descending aorta with usually a VSD and/or PDA associations.

Types of IAA:

  • Type A: interruption just distal to the left subclavian artery (SCA). It represents a severe, complete form of aortic coarctation.
  • Type B: the commonest form; interruption between the left CCA and the left subclavian artery (SCA).
  • Type C: interruption proximal to the left CCA origin.
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Case Information

rID: 35395
Case created: 5th Apr 2015
Last edited: 17th Apr 2017
System: Cardiac
Inclusion in quiz mode: Included

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