title: Magnetic resonance imaging evaluation of recipient for cryopreserved aortic allograft.
abstract: Aortic valve replacement with a cryopreserved aortic allograft is the procedure of choice for many patients with aortic valvular heart disease. We have used magnetic resonance imaging preoperatively to determine annular size and coronary artery orientation in the recipient, which not only has enabled us to select an allograft of appropriate size from a distant tissue bank, but also has helped us to identify preoperatively the recipient with a truly bicuspid valve in which the coronary arteries are oriented 180 degrees apart. Sixteen consecutive patients were evaluated preoperatively, the aortic annulus being measured with both magnetic resonance imaging and echocardiography. Cryopreserved aortic allografts were ordered on the basis of the magnetic resonance imaging measurement. Annular size was then measured intraoperatively with calibrated sizers. Magnetic resonance imaging annular measurements correlated highly with those found at operation (r = 0.92), whereas echocardiographic measurements correlated less well (r = 0.69). Coronary orientation was accurately predicted in every case (r = 1.0). Therefore, we have found magnetic resonance imaging to be useful in the preoperative evaluation of patients for aortic valve replacement with a cryopreserved aortic allograft.
authors.affiliation: Department of Cardiothoracic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.
authors.forename: N D
authors.initials: ND
authors.lastname: Kon
authors.forename: K M
authors.initials: KM
authors.lastname: Link
authors.forename: W P
authors.initials: WP
authors.lastname: Buchanan
authors.forename: A M
authors.initials: AM
authors.lastname: Nomeir
authors.forename: T R
authors.initials: TR
authors.lastname: Downes
authors.forename: A R
authors.initials: AR
authors.lastname: Cordell
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery; D001705:Bioprosthesis; D003331:Coronary Vessels / Q000473:pathology*; D015925:Cryopreservation; D005260:Female; D006349:Heart Valve Diseases / Q000473:pathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care