Rare pattern of aortic arch branching in a patient with operated congenital heart disease

Magnetic resonance imaging (MRI) has become one of the state-of-the-art examinations for the primary diagnostics and follow-up of patients with congenital cardiac defects. The evaluation of the altered cardiovascular system, however, remains a diagnostic challenge. We present MRI findings in a boy with a complex congenital heart defect. To reveal postoperative changes in blood flow dynamics, time-resolved contrast-enhanced 3D MR angiography (CE-MRA) was performed, providing information on altered vessel anatomy and vascular dynamics using spatio-temporal image acceleration. Additionally, an exceptional and rarely described supraaortic vessel variation was detected, consisting of five independent supraaortic arteries. The knowledge of this unusual vessel anomaly detected by CE-MRA might be significant in the case of future therapeutic interventions. J Cardiovasc Med 10:654-656 (C) 2009 Italian Federation of Cardiology.