F. Dagenais et al., MAGNETIC-RESONANCE-IMAGING FOR THE DIAGNO SIS AND FOLLOW-UP OF FALSE ANEURYSMS AFTER BENTALLS OPERATION, Annales de chirurgie, 47(9), 1993, pp. 864-868
The prevalence and natural history of pseudoaneurysm (PA) following Be
ntall procedure has not been established. To determine the follow-up o
f such patients, we report our experience with magnetic resonance imag
ing (MRI) used since 1988. At first, spin-echo exam, PA was suspected
in 19 patients among 27 patients who underwent aortic valve and ascend
ing aortic replacement between 1980 and 1991. Mean PA diameter was < 4
cm in 13 patients (group 1) and greater than or equal to 4 cm in six
patients (group 2). Two patients of group 1 were lost at follow-up whi
le two others died after the first spin-echo exam, one death being rel
ated to PA formation. Repeated MRIs were done in nine patients of grou
p 1 and all patients of group 2 averaging respectively 2.2 +/- 1.1 exa
ms per patient for group 1 and 1.8 +/- 1.1 for group 2. PA regressed i
n six patients of group 1 and one patient of group 2 thus suggesting t
hrombosed PA or postoperative haematoma. PA remained stable in two pat
ients 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, ad
dition of cine MRI allows visualization of turbulent flow within the P
A thus increasing MRT specificity for PA diagnosis. In conclusion, MRI
constitues a reliable and safe noninvasive imaging technique for diag
nosis and follow-up of PA after Bentall repair.