A Case of Turner Syndrome with Coarctation and Subclavian Steal Syndrome by the Left Subclavian Artery from the Descending Aorta Below the Coarcted Segment

ABSTRACT

Juxtaductal coarctation is usually distal to the origin of the left subclavian artery, occasionally the orifice of the subclavian artery is involved in the coarctation and partially obstructed. An anomalous origin of the right subclavian artery from the descending aorta below the coarcted segment is also occasionally encountered. Reversed vertebral artery flow to a subclavian artery arising at or below a coarctation may produce the subclavian steal syndrome. Rarely both subclavian arteries arise beyond the coarctation. These abnormal subclavian arteries are important in clinical diagnosis and treatment. We report a case of Turner syndrome with coarctation, which present as juxtaductal type and the left subclavian artery from the descending aorta below the coarcted segment with reversed vertebral artery flow to a subclavian artery producing the subclavian steal syndrome. Resecton of coarctation segment and end-to-end anastomosis was successfully performed after transfer of left subclavian artery to distal segment of descending aorta.