Author + information
- Received August 13, 2013
- Accepted August 27, 2013
- Published online March 4, 2014.
- J. William Schleifer, MD∗,
- Prasad M. Panse, MD†,
- Hari P. Chaliki, MD∗ and
- Krishnaswamy Chandrasekaran, MD∗
An 81-year-old man with rheumatic heart disease and hypertension presented with dyspnea on exertion. His chest roentgenogram is shown (A). Transthoracic echocardiography showed severe aortic and mitral stenosis. During coronary angiography, the guidewire could not be advanced into the aortic arch. Computed tomography angiography confirmed a previously undiagnosed type A interrupted aortic arch (B to E). Subsequent transesophageal echocardiography studies confirmed the aortic arch connecting with the descending aorta by collaterals only (F to I, Online Videos 1 and 2), with Doppler flow continuing during diastole (J). Based on a recent systematic review, this is the oldest reported case of interrupted aortic arch (1). Therefore, aortic arch anomalies should be considered when evaluating a patient with unexplained hypertension despite age. AA = aortic arch; DA = descending aorta; LA = left atrial; PA = pulmonary artery; Sc = left subclavian artery. ∗Collateral vessel. Arrows = interruption of aortic arch.
- Received August 13, 2013.
- Accepted August 27, 2013.
- American College of Cardiology Foundation