title: Pre- and Postoperative Imaging of the Aortic Root.
abstract: Three-dimensional datasets acquired using computed tomography and magnetic resonance imaging are ideally suited for characterization of the aortic root. These modalities offer different advantages and limitations, which must be weighed according to the clinical context. This article provides an overview of current aortic root imaging, highlighting normal anatomy, pathologic conditions, imaging techniques, measurement thresholds, relevant surgical procedures, postoperative complications and potential imaging pitfalls. Patients with a range of clinical conditions are predisposed to aortic root disease, including Marfan syndrome, bicuspid aortic valve, vascular Ehlers-Danlos syndrome, and Loeys-Dietz syndrome. Various surgical techniques may be used to repair the aortic root, including placement of a composite valve graft, such as the Bentall and Cabrol procedures; placement of an aortic root graft with preservation of the native valve, such as the Yacoub and David techniques; and implantation of a biologic graft, such as a homograft, autograft, or xenograft. Potential imaging pitfalls in the postoperative period include mimickers of pathologic processes such as felt pledgets, graft folds, and nonabsorbable hemostatic agents. Postoperative complications that may be encountered include pseudoaneurysms, infection, and dehiscence. Radiologists should be familiar with normal aortic root anatomy, surgical procedures, and postoperative complications, to accurately interpret pre- and postoperative imaging performed for evaluation of the aortic root. Online supplemental material is available for this article.
authors.affiliation: From the Joint Department of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, Munk Building, 1 PMB-298, 585 University Ave, Toronto, ON M5G 2N2 (K.H.) and the Departments of Radiology (K.H., F.P.C., D.F.) and Cardiothoracic Surgery (R.S.M., D.C.M.), Stanford University School of Medicine, Stanford, Calif.
authors.forename: Kate
authors.initials: K
authors.lastname: Hanneman
authors.affiliation: From the Joint Department of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, Munk Building, 1 PMB-298, 585 University Ave, Toronto, ON M5G 2N2 (K.H.) and the Departments of Radiology (K.H., F.P.C., D.F.) and Cardiothoracic Surgery (R.S.M., D.C.M.), Stanford University School of Medicine, Stanford, Calif.
authors.forename: Frandics P
authors.initials: FP
authors.lastname: Chan
authors.affiliation: From the Joint Department of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, Munk Building, 1 PMB-298, 585 University Ave, Toronto, ON M5G 2N2 (K.H.) and the Departments of Radiology (K.H., F.P.C., D.F.) and Cardiothoracic Surgery (R.S.M., D.C.M.), Stanford University School of Medicine, Stanford, Calif.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Mitchell
authors.affiliation: From the Joint Department of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, Munk Building, 1 PMB-298, 585 University Ave, Toronto, ON M5G 2N2 (K.H.) and the Departments of Radiology (K.H., F.P.C., D.F.) and Cardiothoracic Surgery (R.S.M., D.C.M.), Stanford University School of Medicine, Stanford, Calif.
authors.forename: D Craig
authors.initials: DC
authors.lastname: Miller
authors.affiliation: From the Joint Department of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, Munk Building, 1 PMB-298, 585 University Ave, Toronto, ON M5G 2N2 (K.H.) and the Departments of Radiology (K.H., F.P.C., D.F.) and Cardiothoracic Surgery (R.S.M., D.C.M.), Stanford University School of Medicine, Stanford, Calif.
authors.forename: Dominik
authors.initials: D
authors.lastname: Fleischmann
mesh_terms: D001018:Aortic Diseases / Q000175:diagnosis* / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*