INCISURA OF THE ASCENDING AORTA AND VASCULAR PEDICLE WIDTH IN THE CARDIAC TRANSPLANT PATIENT

Background. The purpose of this study was to evaluate three findings i n cardiac transplant patients: the appearance, etiology, and incidence of ''incisura'' (a characteristic indentation) of the ascending aorta ; the vascular pedicle width, which usually appears enlarged on standa rd chest radiographs; and clearing of the retrosternal clear space. Ma terial. Two hundred sixty-one cardiac transplantations were performed at the University of Minnesota before December 31, 1992. The appearanc e, etiology, and incidence of an incisura were studied; the vascular p edicle width was measured; and the rate of clearing of the retrosterna l clear space was determined. Results. Forty-six percent of the patien ts whose ascending aorta could be visualized on the lateral chest radi ogram showed an incisura. Approximately one third of the patients show ed continued opacification of the retrosternal space postoperatively. The width of the vascular pedicle in this series of cardiac transplant patients measured 60.9 +/- 22.8 mm (standard deviation, 11.4 mm), in comparison to a normal of 48 +/- 5.0 mm. Conclusions. An incisura of t he ascending aorta and the widened vascular pedicle are normal postope rative chest radiographic findings in cardiac transplant patients and should not be misconstrued as abnormalities.