Computed tomography follow-up after elective proximal aortic surgery: Less is more?

Related Experiment Video

Updated: Sep 26, 2025

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
09:32

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging

Published on: December 9, 2021

3.1K

Delano J de Oliveira Marreiros1, Anton Tomšič1, Thomas J van Brakel1

  • 1Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

American Heart Journal
|April 18, 2022
PubMed

Insights

Routine computed tomography (CT) follow-up after proximal aortic surgery is not always beneficial. Aorta-related complications are uncommon and often do not require reintervention, suggesting a conservative CT approach may be suitable.

Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Vascular Surgery

Background:

  • The clinical utility of routine computed tomography (CT) surveillance following elective proximal aortic surgery remains uncertain.
  • Assessing the impact of CT follow-up on detecting aorta-related complications and subsequent reinterventions is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To evaluate the added value of routine computed tomography (CT) follow-up after elective proximal aortic surgery.
  • To determine the incidence of aorta-related complications and reinterventions detected during CT follow-up in patients who underwent proximal aortic surgery.

Main Methods:

  • A retrospective analysis of 314 patients who underwent their first elective proximal aortic surgery between 2000 and 2015.
  • Primary endpoints included aorta-related complications and reinterventions identified during routine CT follow-up; secondary endpoints encompassed all such events regardless of detection method, along with survival data.
  • Median follow-up was 6.8 years with a median of 4 CT scans per patient.

Main Results:

  • Aorta-related complications were detected in 5.7% of patients during CT follow-up, with 1.6% requiring reintervention.
  • In total, 7.3% of patients experienced aorta-related complications, and 9 of these led to reintervention.
  • Detecting one aorta-related complication leading to reintervention required 218 routine CT scans, indicating a low yield.

Conclusions:

  • Aorta-related complications after first-time elective proximal aortic surgery are infrequent and often do not necessitate reintervention.
  • Routine CT follow-up may not always detect clinically significant complications or lead to necessary reinterventions.
  • Consideration of a more selective CT follow-up strategy could reduce radiation exposure and healthcare costs in specific patient groups.
Abstract

More Related Videos

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm04:56

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm

Published on: August 1, 2025

145
Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation06:59

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Published on: June 3, 2018

10.7K

Related Concept Videos

Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
81
Computed Tomography01:10

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
6.4K
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
33
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
37
Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
69
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
37