[Magnetic resonance imaging in the diagnosis and follow-up of false aneurysms after Bentall's operation].
The prevalence and natural history of pseudo-aneurysm (PA) following Bentall procedure has not been established. To determine the follow-up of such patients, we report our experience with magnetic resonance imaging (MRI) used since 1988. At first, spin-echo exam, PA was suspected in 19 patients among 27 patients who underwent aortic valve and ascending aortic replacement between 1980 and 1991. Mean PA diameter was < 4 cm in 13 patients (group 1) and > or = 4 cm in six patients (group 2). Two patients of group 1 were lost at follow-up while two others died after the first spin-echo exam, one death being related to PA formation. Repeated MRIs were done in nine patients of group 1 and all patients of group 2 averaging respectively 2.2 +/- 1.1 exams per patient for group 1 and 1.8 +/- 1.1 for group 2. PA regressed in six patients of group 1 and one patient of group 2 thus suggesting thrombosed PA or postoperative haematoma. PA remained stable in two patients of group 1 and one patient of group 2. One patient of group 1 in whom PA increased at follow-up died suddenly. Four patients of group 2 required surgical correction of their PA. One of these patients died of massive hemoptysis 2 months following reintervention. Recently, addition of cine MRI allows visualization of turbulent flow within the PA thus increasing MRI specificity for PA diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Dagenais
F
F
Département de Chirurgie, Institut de Cardiologie de Montréal, Québec, Canada.
Cartier
R
R
Paquet
E
E
Hudon
G
G
Castonguay
Y
Y
Leclerc
Y
Y
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011792:Quebec; D012086:Reoperation
La résonance magnétique pour le diagnostic et le suivi des pseudoanévrismes après intervention de type Bentall.