CASE 167 Published on 30.07.2000
0

Post-surgical pseudoaneurysm in aortic coarctation

Section

Cardiovascular

Case Type

Clinical Cases

Authors

Bassetti E.,De Santis M, Manganaro F.

Connected authors
Patient

30 years, male

Categories
No Area of Interest ; Imaging Technique MR, MR-Angiography
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Clinical History
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.
Imaging Findings
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).
Discussion
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.
Differential Diagnosis List
Post-surgical pseudoaneurysm in aortic coarctation
Final Diagnosis
Post-surgical pseudoaneurysm in aortic coarctation
Case information
URL: https://www.eurorad.org/case/167
DOI: 10.1594/EURORAD/CASE.167
ISSN: 1563-4086
Figure 1

MR of the thoracic aorta

MR of the thoracic aorta
On T1-W images the distal portion of the aortic arch is postero-laterally surrounded by an aneurysmatic small chamber with clear evidence of internal slow flow .
MR of the thoracic aorta
On T1-W images the distal portion of the aortic arch is postero-laterally surrounded by an aneurysmatic small chamber with clear evidence of internal slow flow .
Figure 2

MR Angiography of the thoracic aorta

MR Angiography of the thoracic aorta
The single partitions of MR angiography confirmed the diagnosis.
MR Angiography of the thoracic aorta
The single partitions of MR angiography confirmed the diagnosis.
MR Angiography of the thoracic aorta
The single partitions of MR angiography confirmed the diagnosis.
MR Angiography of the thoracic aorta
The single partitions of MR angiography confirmed the diagnosis.