MAGNETIC-RESONANCE-IMAGING FOR THE DIAGNO SIS AND FOLLOW-UP OF FALSE ANEURYSMS AFTER BENTALLS OPERATION

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.