Fig. 13

Interruption of the aortic arch with collateral circulation and graft. Mild coronary disease is identified without a hemodynamically significant lesion. a Sagittal MIP demonstrates the interruption (arrow) with a large left common carotid exiting the aortic arch just proximal to the interruption. There is decreased opacification of the distal thoracic aorta relative to the ascending aorta. An aorto-femoral graft extends caudally from the ascending aorta and is visualized in the retrosternal space (arrowhead). b Coronal MIP demonstrates a large, tortuous collateral branch (arrow) extending down from the left external carotid artery to the aortic arch, just beyond the interruption. A mild coarctation is visible in the proximal descending aorta (black arrowhead). This collateral branch and the coarctation were not visible in the sagittal MIP. c Four-chamber view of the heart demonstrates the aorto-femoral graft anteriorly (arrowhead). There is an unusual contour to the right ventricle, which appears to be narrowed in its mid-portion (arrow). d Curved MIP view of the LAD demonstrates non-calcified plaque in the proximal portion of this vessel with mild-moderate—approximately 50%—narrowing (arrow). e Curved MIP view of the LCX demonstrates eccentric calcified plaque in the mid portion of this vessel without narrowing (arrow)