A case of aortic coarctation mimicking an interrupted aorta

An asymptomatic, healthy, 19-year-old male patient was examined for aortic coarctation upon detection of a heart murmur and hypertension on routine physical examination. Transthoracic echocardiography (TTE) showed rupture of the sinus of Valsalva, and bicuspid aortic valve. Findings of aortography and computed tomography (CT) angiography were compatible with an interrupted aorta. For further delineation, transesophageal echocardiography (TEE) was performed and color Doppler imaging showed passage at the site of the descending aorta, which was suggestive of interruption by other imaging methods. The patient underwent surgery for aortic coarctation. At surgery, severe aortic coarctation was noted and corrected. Although TTE is usually adequate for the diagnosis of aortic coarctation, even aortography and CT angiography were misleading in this particular case, and differentiation from interrupted aorta was only possible by TEE.