Figure 23b

Aortic Coarctation and Bicuspid Aortic Valve
This is a case of a 30-year-old man being investigated for a bicuspid aortic valve, chest x-ray showed marked rib notching (arrows in Panel A), due to marked collateral channels from the axillary and internal thoracic arteries. An echocardiogram confirmed a bicuspid aortic valve without stenosis (Panel B), and continuous-wave Doppler scanning of the descending aorta showed marked diastolic runoff consistent with the presence of severe coarctation. An MRI of the chest showed severe focal coarctation (black arrow in Panel C), measuring 1 mm, just beyond the left subclavian artery (which takes off from the aortic arch and goes to the left arm). Numerous large collaterals were present (white arrows). AC denotes anterior cusp, PC posterior cusp, AA ascending aorta, DA descending aorta, ITA internal thoracic arteries, LV left ventricle, and LA left atrium.

Burce, C.J., MB, Breen, J.F., MD, Aortic Coarctation and Bicuspid Aortic Valve, The New England Journal of Medicine, Vol 342, Jan 27-00, p 249 (modified

click to close window