Recanalization of Atretic Aortic Arch in Teenager Guided by Cardiac Magnetic-Resonance: Case Report and Literature
Mohammad Abed1, Shi-Joon Yoo2, Lee N Benson1
1Division of Cardiology, Labatt Family Heart Center, The Hospital for Sick Children, Temerty School of Medicine, Toronto, Ontario, Canada.
Background:
Systemic hypertension secondary to total occlusion of the aortic arch is a rare etiology in children.
Case Summary:
This case report describes the successful management of a 12-year-old girl with an atretic aortic arch by percutaneous recanalization guided by cardiac magnetic resonance (CMR) and angiography. The orientation of the atretic segment seen by CMR suggested a percutaneous intervention would be feasible. A coronary guidewire was used to traverse the atretic arch, and a balloon-expandable covered stent was deployed to restore luminal continuity.
Discussion:
Atretic aortic arch recanalization is a high-risk surgical procedure owing to extensive collateral circulation. CMR plays a key role in preprocedural planning, detailing the vascular anatomy as well as collateral circulation.
Take-Home Message:
This review illustrates the important role of CMR in planning percutaneous interventions as a feasible alternative to high-risk surgical repair in complex anatomies.
Related Concept Videos
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic Regurgitation III: Medical Management
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aneurysm III: Interprofessional Care


