We report a case of an 8-year-old boy with a history of aortopexy for aortic compression and multiple venous thrombosis. A 64-slice multidetector-row computed tomography examination was performed to evaluate the cause of esophageal varices and the extent of previously reported thrombi. Despite extremely low radiation dose settings, the 64-slice computed tomography angiography was fully diagnostic and showed discontinuity of the superior vena cava and brachiocephalic veins. In addition, the azygous system and large collateral vessels across the anterior, medial, and posterior mediastinum and chest wall were observed. This case shows that in pediatric patients complicated vascular pathology can reliably be assessed and radiation exposure can be safely minimized.