Coarctation of the aorta

Fabrice Cuillier, MD*, Arsac L.A., MD, Alessandri J.L., MD**

*    Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.
**      Department of Neonatology, Félix Guyon Hospital, 97400 Saint-Paul, Ile de la Réunion, France.

Case report:

Ms. B. has two previous healthy children.

In this third pregnancy, nuchal translucency was 1.2 mm (60 mm). The triple test was equal to 1:1500. At 24 weeks, fetal echocardiography was normal. 

We met the patient at 34 weeks in our antenatal unit. Ultrasound findings at this time:

  • Large posterior ventricular septal defect (Figure 1, 2), with both identical ventricle size. 

1A-
1C-jpg

  • A thymus of normal appearance.  
  • Large pulmonary artery, but with normal branches (Figure 3-6). 
2A
2B
2C
2E

  • A narrow ascending aorta (Figure 7). 
3A-

  • Narrow aortic arch (Video clip), Two-dimensional echocardiography showed normal curvature of the ascending aorta. 

  • Normal aorta and pulmonary flux (velocity < 100 cm/s). 
  • Normal descending aorta .
  • Frontal edema (Figure 8).
5A

Amniocentesis is done. The karyotype was 46XX, without 22q11 deletion. The couple decide to continue the pregnancy. The child was born at 37 weeks. Diagnosis of aorta coaractation syndrom was confirmed, with these vessel dimensions:

Aorta ring       =        5 mm.
Aorta cross     =        4 mm. 
Aorta isthmus =        2 mm.

The child was transferred to and operated few days later in Paris.

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