European Heart Journal Advance Access originally published online on February 26, 2007
European Heart Journal 2007 28(15):1819; doi:10.1093/eurheartj/ehl553
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Double aortic arch and left superior vena cava persistence visualized by 16-row detector multi-slice computed tomography
1 Cardiology Department, Fondazione Salvatore Maugeri, Via Ferrata 4, 27100 Pavia, Italy
2 Radiology Department, Salvatore Maugeri Foundation, Pavia, Italy
* Corresponding author. Tel: +39 (0)382592611; fax:+39 (0)382592099. E-mail address: etraversi{at}fsm.it
A 38-year-old woman (F.N.) suffering from dysphagia underwent a gastroduodenoscopy. An external compression of the middle portion of the oesophagus was demonstrated. The patient then underwent a 16-row detector multislice computed tomography (CT) (Lightspeed 16 pro, G.E. Medical System, Milwakee, WI, USA) with i.v. administration of iodated non-ionic contrast media (100 mL) and ECG-gated acquisition of the images. A double aortic arch was demonstrated (Panel A). The left carotid (LC) artery and the left subclavian (LS) artery originate from the left arch, whereas the right carotid (RC) artery and the right subclavian (RS) artery from the right (Panel B). This is clearly demonstrated from the endovascular view of the double arch (Panel C). Both the subclavian ostia show a diameter slightly greater than those of the carotid arteries. Along with this malformation, the persistence of the left superior vena cava draining into the coronary sinus and passing anteriorly to the left pulmonary veins was demonstrated. In Panel D, using a particular visualization of the cardiac structures (called ‘transparency’), the relationship between the superior vena cavae and cardiac structures is well valuable. Volume rendering multislice CT images seem particularly useful in complex cardiac and vascular malformations: in this case, with a single non-invasive examination, the origin of the symptoms was explained and a complete picture of the anatomical situation was obtained. This aspect is a further atout of the method when planning for a surgical approach.
Panel A. Volume rendering posterior view of the heart and the aorta. AA, ascending aorta.
Panel B. Volume rendering lateral (left) view of the aorta. Abbreviations as given in Panel A; DA, descending aorta.
Panel C. Intravascular view (‘virtual angioscopy’) of the double aortic arch. Abbreviations as given in Panel A.
Panel D. Volume rendering posterior view of the heart. Transparency reconstruction. DA, descending aorta; IVC, inferior vena cava; PV, pulmonary veins (grey); CS, coronary sinus; LVC, left superior vena cava; RA, right atrium; RVC, right superior vena cava (standard colourization).
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||