Congenital aortic disease

Abstract

Supravalvar aortic stenosis, aortic arch anomalies, and coarctation of the aorta are lesions involving the ascending and descending aortas, which can cause obstruction to left ventricular forward flow. In some cases, they can be associated with an anomalous borderline left ventricle. Obstructive lesions impose an increased afterload on the left ventricle and, if severe and untreated, result in hypertrophy and eventual dilatation and failure of the left ventricle. In addition, clinical manifestations of double aortic arches and other vascular rings include swallowing or respiratory symptoms due to extrinsic compression. In most cases, the anatomical diagnosis can be made from two-dimensional echocardiography. Common indications for performing cardiovascular magnetic resonance (CMR) are to refine an echocardiographic diagnosis before selecting a management plan or during follow-up to depict post-operative changes after surgical correction or catheter intervention. The goals of CMR in the assessment of patients with left-sided heart lesions are anatomical evaluation of the location, functional assessment of the haemodynamic burden, and identification of associated anomalies.