CTICasesAortic Coarctation with Sinus Venosus Atrial Septal Defect and Anomalous Pulmonary Venous Drainage
Imaging findings
CTA revealed a left aortic arch with an aberrant right subclavian artery and a discrete coarctation in the usual location at the ligamentum arteriosum, accompanied by large collateral vessels in the mediastinum. Cardiac MRI demonstrated right ventricular dilation, a sinus venosus type atrial septal defect (ASD) connecting the left and right atria, and anomalous pulmonary venous drainage into the superior vena cava. This combination resulted in a significant left-to-right shunt (3:1 ratio).
Key takeaways
Aortic coarctation is a congenital narrowing of the aorta, typically distal to the left subclavian artery, often leading to prominent collateral circulation. It frequently co-occurs with other congenital heart defects, such as sinus venosus atrial septal defects and anomalous pulmonary venous drainage into the superior vena cava. These combined anomalies can result in significant left-to-right shunting, right ventricular volume overload, and pulmonary hypertension if undiagnosed.
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