Interact CardioVasc Thorac Surg 2008;7:504-505. doi:10.1510/icvts.2007.173054
© 2008 European Association of Cardio-Thoracic Surgery
Brief communication - Congenital |
Incidental dual source computed tomography imaging of ductal aortic coarctation, left subclavian artery stenosis and bicuspid aortic valve in a patient admitted for atypical chest pain
Gorka Bastarrikaa,
Carlo Nicola De Ceccob,*,
Amedeo Anselmic and
Jesus Herrerosd
a Servicio de Radiología, Clinica Universitaria, Universidad de Navarra, Avenida Pio XII, 36. 31008 Pamplona, Spain
b Department of Radiological Sciences, University of Rome ‘Sapienza’, St. Andrea Hospital, Via di Grottarossa, 1035. 00189 Rome, Italy
c Division of Cardiac Surgery, Catholic University, Largo Agostino Gemelli, 8. 00100 Rome, Italy
d Departamento de Cardiocirurgia, Clinica Universitaria, Universidad de Navarra, Avenida Pio XII, 36. 31008 Pamplona, Spain
Received 5 December 2007;
received in revised form 13 February 2008;
accepted 15 February 2008
*Corresponding author. Tel.: +39-3355259926; fax: +39-0644260834.
E-mail address: carlodececco{at}gmail.com (C.N. De Cecco).
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Abstract
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A case of incidental ductal aortic coarctation with left subclavian artery stenosis at the origin, severely calcified and stenotic bicuspid aortic valve, and normal coronary arteries demonstrated by single breath hold dual source computed tomography angiography in a 46-year-old man admitted for acute chest pain is presented.
Key Words: Aortic coarctation; Dual source computed tomography; Aorta; Congenital; Angiography
A 46-year-old man was admitted into hospital for acute chest pain. A cardiac dual source computed tomography (CT) examination (Somatom Definition, Siemens Medical Solutions, Forchheim, Germany) was performed to evaluate thoracic vessels and rule out coronary artery disease. Within a single breath hold, moderate ductal coarctation of the aorta (maximum diameter, 15.0 mm; area, 2.8 cm2) without significant collateral vessels, severe stenosis at the origin of the left subclavian artery, mild post-stenotic descending aortic dilatation, severely calcified bicuspid aortic valve, concentric left ventricular hypertrophy (Fig. 1, Video 1), and normal coronary arteries with a left dominant system (Fig. 2) was demonstrated. The patient underwent surgery for aortic valve replacement. No preoperative conventional coronary angiography was performed.
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Fig. 1. Dual source CT images. (a) Coarctation of the aorta located at the insertion of the ductus arteriosus (arrow). Severe stenosis at the origin of the left subclavian artery (arrowhead). (b) The volume rendered image nicely demonstrated the aortic coarctation and normal coronary arteries. (c) Severely calcified bicuspid aortic valve. (d) Left ventricular hypertrophy due to aortic valve stenosis.
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Fig. 2. Normal coronary arteries. (a) Left anterior descending artery. (b) Circumflex artery (left dominant system). (c) Right coronary artery. (d) Volume rendered image of the coronary tree.
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References
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