PSEUDOANEURYSM AFTER BENTALL REPAIR - MAGNETIC-RESONANCE-IMAGING ASSESSMENT

The prevalence and natural history of pseudoaneurysms (PA) following B entall procedure has not been established. To determine the follow-up of PA in patients, the authors report their experience with magnetic r esonance imaging (MRI) since 1988. Spin-echo technique suspected PA in 19 of the 27 patients who underwent aortic valve and ascending aortic replacement between 1980 and 1991. Mean PA diameter were less than 4 cm in 13 patients (group 1) and at least 4 cm in six patients (group 2 ). Two patients in group 1 were lost at follow-up while two others in this group died after first spin-echo examination (one death was relat ed to PA formation). Repeated MRIs were thus possible in nine patients in group 1 and in all patients in group 2, averaging 2.2+/-1.1 examin ations per patient from group 1 and 1.8+/-1.1 for group 2. PA assessed in six group 1 patients and one group 2 patient suggested thrombosed PA or postoperative hematoma. PA remained stable in two group 1 patien ts and one group 2 patient. One patient from group 1, in whom PA incre ased at follow-up, died suddenly. Four patients in group 2 required co rrection of PA, which had increased in diameter. Recently, addition of cline MRI has allowed visualization of turbulent flow within PA, thus increasing MRI specificity for PA diagnosis. In conclusion, MRI const itutes a reliable noninvasive imaging technique for diagnosis and foll ow-up of PA after Bentall repair.