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Ann Thorac Surg 1999;68:1421
© 1999 The Society of Thoracic Surgeons

Images in Thoracic Surgery

Aortic pseudo-coarctation: spiral volumetric computed tomography imaging

Paolo Masiello, MDa, Giuseppe Santoro, MDa, Emilio Franzesi, MDb, Laura De Lillo, MDb, Onofrio Fittipaldi, MDa, Giuseppe Di Benedetto, MDa

a Division of Cardiac Surgery, "S. Giovanni di Dio e Ruggi D’Aragona" Hospital, Salerno, Italy
b Division of Radiology, "S. Maria dell’Olmo" Hospital, Cava de’ Tirreni (SA), Italy

Address reprint requests to Dr Masiello, Piazza V. Veneto 39, 84123 Salerno, Italy
e-mail: pmasiell{at}tin.it

Aortic pseudo-coarctation is a quite rare cardiovascular malformation characterized by a redundant and severely kinked aortic arch without a significant transisthmic pressure gradient. Diagnostic assessment is usually performed by angiography or other imaging techniques.

A 7-year-old child was submitted to cardiologic exam-ination for suspected aortic coarctation. Angiography was performed. It showed the aortic arch kinking (aortic pseudo-coarctation) with a peak-to-peak pressure gradient of 25 mm Hg across the aortic isthmus without collateral circulation. To better visualize the aortic branching pattern, a spiral computerized tomography scan was performed.

Surgery was not advised, and it was planned to routinely follow the patient by clinical and noninvasive examinations. Fig..



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  		Fig.. (A) Aortogram in left anterior oblique view, showing a kinking of the aortic arch starting distally from the left common carotid artery. (B) Volumetric spiral computed tomography scan image acquired after nonionic contrast bolus and reconstructed by a three-dimensional display algorithm. The kinking of the aorta is impressively shown (arrows).

 



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