A calcified sinutubular junction: the discovery of a supravalvular aortic stenosis in an elderly woman

Abstract

We report a case of a 64 year old woman with a calcified ring at the level of the sinotubular junction. Echocardiography and Computed Tomography showed a supravalvular aortic stenosis, without known associated lesions, except for the existence of an aberrant right subclavian artery. These combination of abnormalities makes it an unique case. Differential diagnosis of sinutubular calcification is added. From the literature a short review of supravalvular aortic stenosis is presented with indications for surgical intervention. Lifelong and regular follow up is necessary.

Fig. 1

Cardiac echocardiography with apical views demonstrating the SVAS (a, left, arrow). Pulsed-wave Doppler measurement shows a maximal velocity of 1.8 m/s across the stenosis (b, middle). Colour Doppler visualises the turbulence at the level of the ST junction (c, right)

Fig. 2

CT images in a three-chamber plane. Thick (a, left) and thin (b, right) slice maximum intensity projection (MIP) reconstructions, visualising the calcified ST ridge

Fig. 3

CT MIP reconstructions. Axial-oblique plane (a, left) showing the calcified ring (arrow, SVAS) and axial plane (b, right) showing the aberrant right subclavian artery (arrow, LUSORIA) originating from the distal arcus aortae (arrow, ARCUS)