Presentation
Weakness and fatigue with hypertension. Chest X-ray revealed mild cardiomegaly with left ventricular enlargement.
Patient Data
Age: 18 years
Gender: Female
From the case:
Interrupted aortic arch (type A)
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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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