Severe cases of CoA may have a complete loss of luminal continuity and progression into the complete obstruction as well. We reported a case of type A IAA with the complete anatomic discontinuity of aortic arch immediately distal to subclavian artery origin and with a conspicuous distance between the interrupted aortic arch and the descending segment of the thoracic aorta. No other aneurysm was detected in the rest of the body. Aortic root showed a bicuspid aortic valve morphology with thick and calcified valvular flaps and an enlargement of the tubular segment of the ascending thoracic aorta was reported. Collateral circulation was evident from the internal mammary artery, in particular, the left one. Both collateral arteries presented proximal voluminous aneurysms, the biggest on the right side with endoluminal dissection flap 3A] and at least three on the left side. The thoracic descending aorta was bilaterally refilled, distally to interruption, by collaterals of subclavian arteries arisen after vertebral arteries origin. Arterial duct appeared fibrotic and partially calcified. Distance between the interrupted aortic arch and the descending segment of the thoracic aorta was more than 4.5 cm. The CTA study showed a complete interruption of aortic arch distally to subclavian artery origin, 2A], reported as type A IAA. She referred to experiencing pain in the chest and right upper limb since the last 10 months, more intense in the last days.īecause of her history and the intensification of symptoms, she underwent an ECG-synchronized computed tomography angiogram (CTA) of the heart and thoracic aorta and a subsequent, not ECG-synchronized scan extended from brain to pelvis to exclude other vessels malformations. A 52-year-old woman with a not better-specified history of thoracic great vessel malformation presented to the emergency department upon indication of her primary care physician.
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