Interrupted aortic arch with post-interruption aneurysm and bicuspid aortic valve in an adult: a case report and literature review

Abstract

Interrupted aortic arch in adults is rare with a limited number of reported cases. We describe a case of a 53-year-old woman with interrupted aortic arch, bicuspid aortic valve, and post-interruption saccular aneurysm of the aorta. To our knowledge, this is only the second report of an adult patient with all 3 abnormalities. We also review the literature on this unusual condition and discuss its relationship with coarctation of the aorta.

Keywords: Aortic aneurysm; Aortic coarctation; Bicuspid aortic valve; Interrupted aortic arch.

Fig. 1

Images from CT angiogram in a 53-year-old woman presenting with paroxysmal palpitations and shortness of breath who was subsequently diagnosed with type A interruption of the aortic arch. (A) Reformatted oblique sagittal image of the thoracic aorta shows interruption of the aorta (white arrow) just distal to the origin of the left subclavian artery (black arrow). Note the maintenance of curvature of the ascending aorta and the presence of a small portion of the distal arch (arrowhead) just distal to the origin of the subclavian artery. (B) Volume-rendered image from a left lateral projection depicts the interruption. Note the dilated internal mammary artery (white arrow) and dilated intercostal arteries (arrowheads). (C) Axial image shows saccular aneurysm (arrow) extending from the descending thoracic aorta (marked A). (D) Reformatted oblique coronal image shows the saccular aneurysm (white arrow) extending from proximal descending thoracic aorta (marked A) just distal to the interruption (white arrowhead). (E) Reformatted view through the plane of the aortic valve shows bicuspid aortic valve morphology (arrows). LA, left atrium; RA, right atrium.