Composite Graft Replacement of the Ascending Aorta: Leakage Detection with Gadolinium-enhanced MR Imaging

Fattori, Rossella; Descovich, Benedetta; Bertaccini, Paola; Celletti, Francesca; Caldarera, Ilaria; Pierangeli, A; Gavelli, Giampaolo

doi:10.1148/radiology.212.2.r99au02573

Cited by 21 publications

(7 citation statements)

References 16 publications

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“…Adjunctive repairs may involve tearing of the coronary buttons and possible damage of the coronary ostia with consequent myocardial ischaemia. Postoperative coronay ostial complications may also occur [10][11][12][13][14]. Pseudoaneurysms at the site of suture line of coronary buttons, postoperative aneurysms of the surrounding aortic tissue of coronary buttons, coronary kinking, and narrowing of reimplanted coronary ostia.…”

Section: Commentmentioning

confidence: 99%

“…In the present study we evaluated early postoperative angiographic results of the "Button inside" technique in this first series of patients using non invasive new imaging technologies. The high performance of MRI angiography to detect postoperative complications after ARR may also increase the visualization of small pseudoaneurysms of coronary buttons non detectable by postoperative two-dimensionally echocardiography [11,12,14]. Moreover, MRI angiography may be reproduced several times and may represent the best non invasive choice for postoperative angiographic follow-up of patients operated on ARR expecially when postoperative leakages of the prosthetic aortic segment and coronary button anastomoses are present in asymptomatic patients treatable by urgent reoperation.…”

Section: Commentmentioning

confidence: 99%

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Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement

Canosa¹,

Nasso²,

Restaino³

et al. 2012

WJCS

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Background and Aim: The Button technique was the operative technique generally used for the reimplantation of coro- nary arteries in the aortic root replacement because of reduced anastomotic complications respect to the original wrapped operation described by Bentall and De Bono. The “Button Inside” technique is a modified Button technique recently performed in all consecutive series of patients operated on aortic root replacement at our Institution. In this study we report early postoperative angiographic results of patients operated on aortic root replacement using the “But- ton Inside” technique. Methods: Magnetic Resonance Imaging angiography was achieved in all patients operated on aortic root replacement. Morphological characteristics of the site of coronary buttons reattachment were accurately evaluated. Results: No postoperative anastomotic leakages were detected at the site of coronary buttons anastomosis. Moreover, in this first series of postoperative control aneurisms of coronary buttons were not detected. Conclusions: Early postoperative non-invasive angiographic results of the “Button Inside” technique are encouraging. This surgical approach for the reattachment of coronary arteries is suggested in aortic root replacement when is possible to mobilize coronary arteries in order to reduce coronary artery anastomotic complications

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement

Canosa¹,

Nasso²,

Restaino³

et al. 2012

WJCS

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show abstract

“…The higher incidence of bleeding has been reported at the site of reimplanted coronary arteries. Gadolinium-enhanced MRI with standard spin-echo sequences can provide detailed information on suture detachment [52]; the site of bleeding appears as high signal intensity within the hematoma. Moreover, Gadolinium-enhanced MRA is particularly effective in the depiction of the complex postoperative anatomy and in elucidating the prosthetic tube, distal and proximal anastomoses and residual distal dissection and eventually dilated segments.…”

Section: Aortic Ulcersmentioning

confidence: 99%

Acquired diseases of the thoracic aorta: role of MRI and MRA

et al. 2005

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Diseases of the thoracic aorta can present with a broad clinical spectrum of symptoms and signs. Their prevalence appears to be increasing in western populations, most likely corresponding to aging and heightened clinical awareness but also influenced by the progress of high-resolution, noninvasive imaging modalities. Among them, MRI provides an excellent visualization of vascular structures and is well suited for evaluation of thoracic aorta disease. Currently, in many centers, noninvasive imaging modalities are the first choice in the cardiovascular system evaluation and diagnosis, reserving conventional angiography for use only before therapeutic intervention. Understanding the principle MRA techniques is essential for acquiring consistent diagnostic images. Basic technical considerations, which include fast spin-echo, fast gradient-echo, and MRA techniques with phase contrast and contrast-enhanced methods, are discussed and applied in the evaluation of acquired thoracic aorta diseases.

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“…Suture detachment has been reported after composite graft replacement of the ascending aorta [25]. Gadolinium-enhanced SE-MRI is capable of providing detailed information on suture detachment [10], highlighting the site of bleeding by high signal intensity within the hematoma.…”

Section: Abbildungmentioning

confidence: 99%

Aortic Diseases - Do We Need MR Techniques?

Nienaber

Fattori²

2000

Herz

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MR with its various imaging protocols including spin-echo MR-imaging, gradient MR imaging, flow-mapping and MR angiography is the ideal tool for noninvasive assessment of any kind of aortic diseases. The technique allows to image the aorta both in the thoracic cage and in the abdominal aspects better than any other tomographic image modality. With the capability of angiography after intravenous injection of gadolinium even the information previously only obtained from invasive catheter-based studies is now available within minutes after an intravenous injection. The overview manuscript compares various clinical settings of aortic diseases as assessed by various imaging modalities and highlights the capability of MR-imaging for aortic diseases both in the chronic and the acute clinical setting.

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Composite Graft Replacement of the Ascending Aorta: Leakage Detection with Gadolinium-enhanced MR Imaging

Abstract: MR imaging was an optimal imaging modality for evaluating the morphologic characteristics of composite grafts and reimplanted coronary arteries. Gadolinium-enhanced MR imaging is a simple, accurate, and noninvasive method for detecting a leak, which necessitates urgent repeat surgery.

Cited by 21 publications

References 16 publications

Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement

Early Non-Invasive Angiographic Results of the “Button Inside” Technique for the Reattachment of Coronary Arteries in the Aortic Root Replacement

Acquired diseases of the thoracic aorta: role of MRI and MRA

Aortic Diseases - Do We Need MR Techniques?

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