Related Experiment Videos
MRI postoperative monitoring in patients surgically treated for aortic dissection
E Di Cesare1, A Costanzi, F Fedele
1Department of Radiology, University of L'Aquila, Italy.
Abstract:
In most cases, surgery of aortic dissections repairs only the ascending portion of the aorta, leaving a residual dissection in the arch and descending aorta. We studied 17 patients operated upon for type A aortic dissection. A total of 42 magnetic resonance imaging (MRI) examinations were performed, with two to five studies per patient (mean 2.47). The studies were done between 5 weeks and 47 months (mean 17.5 months) after surgery. The patients were evaluated by MRI using gated spin-echo and gradient-echo sequences on axial and oblique sagittal views, and in selected cases, coronal views. A high incidence of abnormalities was observed. Pericardial hematoma was observed in 11% of cases, aortic and branch involvement in 41%, abdominal aortic branch involvement in 47%, dilatation of native aorta in 58%, and extension of dissection in 10%. New complications were detected during follow-up in 53% of patients. MRI was helpful in the follow-up of patients operated upon for aortic dissections, owing to its noninvasiveness and multiplanarity. By means of this technique, it was possible to obtain information about the natural history of the disease, as well as information useful for subsequent treatment.
Insights
Follow-up imaging using magnetic resonance imaging (MRI) reveals frequent abnormalities and new complications in patients after type A aortic dissection surgery. This noninvasive technique aids in understanding disease progression and guiding further treatment.
Area of Science:
- Cardiovascular Surgery
- Diagnostic Imaging
- Radiology
Background:
- Surgery for type A aortic dissection often leaves residual disease in the aortic arch and descending aorta.
- Long-term monitoring is crucial for patients post-dissection repair.
Purpose of the Study:
- To evaluate the utility of magnetic resonance imaging (MRI) in monitoring patients after type A aortic dissection surgery.
- To assess the incidence of abnormalities and new complications in the long term.
Main Methods:
- Retrospective analysis of 42 MRI examinations in 17 patients operated for type A aortic dissection.
- Studies were performed 5 weeks to 47 months post-surgery.
- Utilized gated spin-echo and gradient-echo sequences in multiple planes.
Main Results:
- High incidence of abnormalities including pericardial hematoma (11%), aortic/branch involvement (41%), abdominal aortic branch involvement (47%), native aorta dilatation (58%), and dissection extension (10%).
- New complications were detected in 53% of patients during follow-up.
- MRI demonstrated noninvasiveness and multiplanarity for effective patient monitoring.
Conclusions:
- MRI is a valuable, noninvasive tool for the long-term follow-up of patients after aortic dissection repair.
- Findings provide insights into the natural history of residual disease and inform subsequent treatment decisions.