Childhood presentation of interrupted aortic arch with persistent carotid ducts.

Interrupted aortic arch is a rare condition with typical presentation within the first few weeks of life, as the circulation is dependent upon patency of the arterial duct. Most cases are associated with intracardiac anomalies, the most common being a ventricular septal defect with some degree of hypoplasia and/or obstruction of the left ventricular outflow tract. Presentation beyond infancy is uncommon, and suggests the presence of well-developed collateral circulation. This case of childhood presentation of interrupted aortic arch and intact ventricular septum highlights the very unusual finding of bilateral collateral arteries consistent with persistent carotid ducts. Cardiac MRI angiography with three-dimensional reconstruction defined not only the site of interruption in the aortic arch but also the entire collateral circulation.