Post-ductal coarctation of the thoracic aorta in an infant
Differential pulses in the arms and legs with weak pulses in the leg. Chest x-ray revealed mild cardiomegaly with left ventricular enlargment.
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· 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.
· 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.
Post-ductal coarctation of the thoracic aorta.
The case is courtesy of Dr. Mohammad A. ElBeilay, and Dr. Heba Mounir.
- 1- Gopal A, Loewinger L, Budoff MJ. Aortic coarctation by cardiovascular CT angiography. Catheter Cardiovasc Interv. 2010;76 (4): 551-2. doi:10.1002/ccd.22614 - Pubmed citation
- 2- Miabi Z, Pourfathi H, Midia M et-al. Comparison of CT angiography and digital subtraction angiography in the diagnosis of aortic coarctation. Pak. J. Biol. Sci. 2011;14 (1): 74-7. Pubmed citation