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Left cervical aortic arch with aortic coarctation and saccular aneurysm
1The Third Department of Internal Medicine, University of Tokyo, Japan. imaiycard-tky@umin.ac.jp
Insights
A rare cervical aortic arch with coarctation and aneurysm caused severe hypertension. Surgical repair corrected the aortic defects, improving blood pressure but requiring ongoing medication.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Congenital Heart Disease
Background:
- Cervical aortic arch is a rare congenital anomaly.
- It can be associated with other cardiovascular abnormalities.
- This case highlights a complex presentation with coarctation and aneurysm.
Observation:
- A 48-year-old male presented with a left cervical aortic arch.
- Clinical findings included severe upper body hypertension (50 mmHg gradient) and a continuous murmur.
- Magnetic resonance angiography confirmed the aortic malformations.
Findings:
- Surgical resection of the aortic coarctation and aneurysm was performed.
- Thoracic aorta reconstruction was successfully completed.
- Postoperative blood pressure discrepancy significantly reduced.
Implications:
- This case demonstrates successful surgical management of a complex cervical aortic arch malformation.
- Early diagnosis and intervention are crucial for managing associated hypertension and vascular defects.
- Long-term antihypertensive medication may still be necessary.
Abstract:
Cervical aortic arch is a very rare malformation and is occasionally accompanied by other cardiovascular anomalies. A 48-year-old male patient had a left cervical aortic arch with aortic coarctation and saccular aneurysm distal to the coarcted segment. The major clinical manifestations were upper body hypertension with a 50-mmHg discrepancy between the upper and lower limbs and a loud continuous murmur in the upper chest and back. Magnetic resonance angiography successfully depicted the anomalous aorta, and the aortic coarctation and aneurysm were surgically resected and the thoracic aorta was reconstructed. The discrepancy in blood pressure diminished after the operation, but antihypertensive medication was continued to satisfactorily control the hypertension.