Illustration of a heart with double aortic arch, highlighting the use of 3D imaging for treatment planning.

Rare Heart Condition? A Groundbreaking PCI Procedure Offers New Hope!

Rhea Morgan in Health & Wellness November 2025 • 4 min read.

"A 3-D road map to success: How advanced imaging is changing the game in treating double aortic arch and preventing heart failure."

Imagine your heart’s highway system having a rare, complex detour – that’s what a double aortic arch (DAA) can be like. Recently, doctors encountered this exact scenario: a 77-year-old man rushed to the hospital, his heart struggling, chest pains flaring, and an electrocardiogram revealing worrying changes.

Initial tests painted a concerning picture. The man's heart wasn't pumping blood efficiently, and a chest X-ray showed his aorta – the body's largest artery – was oddly positioned. To get a clearer view, doctors used a sophisticated imaging technique called coronary computed tomography angiography (CTA).

The CTA unveiled the full complexity of the situation: the patient had a double aortic arch, a rare birth defect where the aorta splits into two arches. In this case, one arch was the main channel, while the other was narrow and partially blocked. Adding to the challenge, the patient’s arteries had a severe blockage. This intricate anatomy made a standard heart procedure risky.

Navigating the Maze: How 3-D Imaging Made the Impossible Possible

Illustration of a heart with double aortic arch, highlighting the use of 3D imaging for treatment planning.

Typically, doctors might use the femoral (leg) or radial (wrist) arteries to access the heart for a percutaneous coronary intervention (PCI), a procedure to open blocked arteries. However, in this patient’s case, those routes were unusable due to the unusual anatomy. The team needed a plan, and fast.

That’s where 3-D computed tomography angiography (CTA) played a crucial role. Think of it as creating a detailed, three-dimensional road map of the patient's heart and blood vessels. This advanced imaging allowed the doctors to:

Visualize the double aortic arch clearly, understanding the size and position of each arch.
Identify the exact location of the blockage in the left anterior descending artery, a critical vessel supplying blood to the heart.
Plan the safest and most effective route for the PCI procedure, avoiding damage to the delicate aortic arches.

Armed with this detailed map, the medical team chose a right transradial approach, accessing the heart through the wrist artery on the right side. The PCI was performed without complications, and the patient's heart function improved.

A New Era of Precision in Heart Care

This case highlights the power of advanced imaging in treating complex heart conditions. By using 3-D CTA, doctors can navigate challenging anatomies, personalize treatments, and ultimately, save lives. As technology advances, we can expect even more precise and effective approaches to treating heart disease.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jcin.2018.08.032, Alternate LINK

Title: Successful Percutaneous Coronary Intervention In A Double Aortic Arch With A Right Descending Aorta

Subject: Cardiology and Cardiovascular Medicine

Journal: JACC: Cardiovascular Interventions

Publisher: Elsevier BV

Authors: Yusuke Sato, Tetsuji Morishita, Hiroyasu Uzui, Hiroshi Tada

Published: 2018-11-01

Everything You Need To Know

What exactly is a double aortic arch (DAA) and why is it considered a rare heart condition?

A double aortic arch (DAA) is a rare congenital condition where, instead of having a single aorta, a person is born with two aortic arches. This can create a vascular ring around the trachea and esophagus, potentially leading to breathing or swallowing difficulties. The severity depends on the size and configuration of the two arches. In some cases, like the one described, one arch might be narrower or partially blocked, complicating the situation further. The condition often requires careful diagnosis and a tailored treatment plan, especially when other heart conditions are present.

How does coronary computed tomography angiography (CTA) provide a clearer picture of heart conditions compared to traditional methods?

Coronary computed tomography angiography (CTA) is an advanced imaging technique that uses X-rays and computer technology to create detailed, three-dimensional images of the heart and coronary arteries. It's more comprehensive than a standard X-ray, allowing doctors to visualize the heart's anatomy, including the aorta, with much greater clarity. In the case of the patient with the double aortic arch (DAA), CTA was crucial for understanding the exact size, position, and configuration of both arches, as well as identifying blockages in other arteries. This detailed visualization is essential for planning complex procedures.

What is percutaneous coronary intervention (PCI), and what challenges does a double aortic arch (DAA) present for this procedure?

Percutaneous coronary intervention (PCI) is a minimally invasive procedure used to open blocked coronary arteries, improving blood flow to the heart. Typically, doctors access the heart through arteries in the leg (femoral artery) or wrist (radial artery). However, in patients with a double aortic arch (DAA), the unusual anatomy can make these standard access routes unusable or risky. In such cases, advanced imaging like 3-D computed tomography angiography (CTA) is essential for identifying alternative access points and planning the PCI procedure to avoid damaging the delicate aortic arches.

In the described case, how did 3-D computed tomography angiography (CTA) specifically help doctors navigate the complexities of the double aortic arch during the PCI procedure?

3-D computed tomography angiography (CTA) played a vital role by providing a detailed, three-dimensional "road map" of the patient's heart and blood vessels. This allowed doctors to clearly visualize the double aortic arch (DAA), understand the size and position of each arch, and identify the exact location of the blockage in the left anterior descending artery. With this information, they could plan the safest and most effective route for the percutaneous coronary intervention (PCI) procedure, ultimately accessing the heart through the right transradial approach, which would have been impossible to confidently select without this imaging.

What are the broader implications of using advanced imaging like 3-D computed tomography angiography (CTA) in treating rare and complex heart conditions such as double aortic arch (DAA)?

The successful percutaneous coronary intervention (PCI) using 3-D computed tomography angiography (CTA) for planning demonstrates a significant advancement in treating patients with complex heart conditions, specifically those with a double aortic arch (DAA). This precision allows for personalized treatment plans, minimizing risks and improving outcomes. As technology continues to evolve, we can expect even more sophisticated approaches to treating heart disease, potentially leading to less invasive procedures and better long-term results for patients with rare and challenging anatomies. Missing from this context is a discussion of long-term monitoring or potential surgical interventions if the PCI is not fully effective or if other complications arise.