Post-ductal coarctation of the thoracic aorta in an infant

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Differential pulses in the arms and legs with weak pulses in the leg. Chest x-ray revealed mild cardiomegaly with left ventricular enlargment.

Patient Data

Age: 6 months
Gender: Male

Heart:

·         Situs solitus with the cardiac apex to the left.

·         Atrio-ventricular concordance and ventriculo-arterial concordance.

·         Mild cardiomegaly with concenteric hypertrophy of the left ventricle and mild left atrial dilatation.

Aorta:

·         The ascending thoracic aorta measuring about 1.13 cm in its maximum diameter (at the level of MPA). It measures 0.91 cm at the sinotubular junction, 1.13 cm at the sinuses, and 0.65 x 1.14 cm at the annulus.

·         Normal origin and course of the coronary arteries.

·         Left sided bovine aortic arch with the Lt CCA and the brachiocephallic have common origin. It measures 0.75 cm in diameter.

  • The aortic isthmus measures 0.64 cm. It arises just after the Lt SCA origin.
  •  Coarctation of the aorta is seen 1.5 cm distal to the origin of the Lt SCA that measures about 0.40 cm in diameter ,0.25 cm in length. Distal to the coarctation, the descending aorta shows mild post-stenotic dilation measuring 0.83 cm at its widest diameter. It is .
  • The descending aorta is seen running in the normal left para-vertebral course and of about 0.82 cm in diameter (measured at the level of the diaphragm).

Pulmonary Arteries & Veins

  • Confluent main pulmonary artery and its branches. No pulmonary stenosis is noted. The MPA measures 0.85cm and 1.06 cm (proximally and distally respectively)
  • The RPA is a uniform vessel. It measures 0.89cm and 0.94cm (proximally and distally respectively)
  • The LPA is small and measures 1 cm and 0.72cm (proximally and distally respectively).
  • Normal pulmonary veins. No evident anomalous pulmonary venous drainage. The left pulmonary veins drain in a common vein before entering the left atrium.

Venae Cava &Innominate Veins

Normal course of the innominate veins, SVC and the visualized segment of the IVC. SVC measures 0.73cm.

Case Discussion

Post-ductal coarctation of the thoracic aorta.

 

The case is courtesy of Dr. Mohammad A. ElBeilay, and Dr. Heba Mounir.

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Case Information

rID: 35444
Case created: 6th Apr 2015
Last edited: 4th Dec 2016
System: Cardiac
Inclusion in quiz mode: Included

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