An Extremely Unusual Case of Type A Interrupted Aortic Arch in a Young Male

Abstract

A young male patient of 20-year-old came to our hospital for evaluation of hypertension in young. The patient has presented with symptoms of dizziness and heaviness of the head for past 3 months. ECHO was suggestive of coarctation of the aorta and was evaluated for the same with catheter angiography study. Aortograms were taken through both right brachial and femoral routes. Transfemoral catheter failed to pass beyond the proximal descending thoracic aorta, and flush angiograms showing aortic stump are taken. Transbrachial artery catheter angiogram showed abrupt cut off of the arch of aorta distal to the origin of the left subclavian artery. It was interpreted as severe coarctation of aorta and stent dilatation was planned during the same sitting. However even guide wire was not negotiable through the segment and procedure was abandoned. For proper delineation of aortic anatomy, multislice computed tomography (CT) angiography was performed which showed complete discontinuity of lumen of the aorta between the aortic arch and descending thoracic aorta which is separated by an atretic fibrous band of thickness ~3.2 mm suggestive of interruption of the aorta (type A).