Author(s)

Bassetti E.,De Santis M, Manganaro F.

Patient

male, 30 year(s)

30 years old male patient with coarctation of aorta underwent surgical treatment followed by unexpected thoracic pain. Surgical complication was suspected on TEE evaluation e definetively confirmed on MR examination. 30 years old male patient with coarctation of aorta underwent surgical treatment followed by unexpected thoracic pain. Surgical complication was suspected on TEE evaluation e definetively confirmed on MR examination.

30 years old male patient with known diagnosis of aortic coarctation (infantile type) underwent surgical repair. After few days he developed thoracic pain. A TEE evaluation raised the suspicion of surgical complication at coarctation site and thus the patient underwent MR examination of the thoracic aorta. On T1-W images the distal portion of the aortic arch was postero-laterally surrounded by an aneurysmatic small chamber with clear evidence of internal slow flow (Fig 1a,b). The single partitions of the subsequent MR angiography confirmed the diagnosis (Fig. 2a,b,c,d).

The infantile type of aortic coarctation, less commonly observed than the adult one, is characterized by tubular hypoplasia of a long segment of aortic arch after innominate artery origin. In this case, the extremely delayed surgical approach until adulthood has been related to a low-degree coarctation. Ascertaining the exact point of communication between the post-surgical pseudoaneurysm and the true lumen as well as the aortic morphology above the former one are fundamental informations for the surgeon in order to plan an optimal re-surgical approach, informations that are readily available by means a complete (black-blood, angio) MR examination.