An extremely rare abnormality of the aortic arch: intra-aortic chord

A 41-year-old man presented with chest tightness and pain without obvious inducement 1-year ago. The symptoms were not severe. Laboratory examination and echocardiogram are normal. Computed tomography angiography (CTA) showed the presence of an intra-aortic chord, traversing the aortic arch (AA) (Panels A–C). The length of the chord is about 20.8 mm, and the width is 1.6 mm, which resembles the intimal flap of dissected aortic (AD). Volume rending reconstructions clearly demonstrated the intra-aortic chord crossing the lumen of the AA (Panels D–F). Cine balanced steady-state free precession magnetic resonance imaging (BSSFP-MRI) (Panel G) and Contrast-enhanced magnetic resonance angiography (MRA) (Panels H and I) demonstrated the intra-aortic chord arising from an ostium of left subclavian artery (LSA) and traversing the AA. Intra-aortic chord is an extremely rare entity. It may be derived from a congenital tissue remnant. CTA and MRI show a...