Abstract
Long-term survival after replacement of the aortic root with a composite graft is
improving. Late deaths are in several cases due to complications related to the previous
surgery or to pathologies of the remaining aorta. Regular follow-up of these patients
is of paramount importance. The purpose of this study is to evaluate the reliability
of magnetic resonance imaging (MRI) in such cases. Twenty-seven patients (9 dissections
and 18 aneurysms) who had undergone replacement of the aortic root with a composite
graft were studied 20 to 167 months after surgery using magnetic resonance imaging
with a 1.5 Tesla magnet. The left-ventricular outflow tract, the mechanical valve
function, the proximal part of the coronary arteries, the graft, and the remaining
aorta could be examined. No aortic insufficiency, ectasy of the proximal part of the
coronaries, or pseudoaneurysms were seen. A widening of the remaining ascending aorta
was noted in 4 cases. A still open, dissected pipe was visualized in 7 patients. Our
conclusions are that MRI provides excellent images of the thoracic and abdominal aorta
following surgical repair. The examination is becoming cost-competitive. More import
is its very low risk for the patient group considered here: since it is non-invasive
and requires no contrast medium or X-ray exposure, examinations can be repeated as
required.
Key words
MRI - Aortic dissection - Aortic aneurysm - Followup
