Long-term follow-up of 82 patients with chronic disease of the thoracic aorta using spin-echo and cine gradient magnetic resonance imaging

The objective of this study to examine the clinical impact of magnetic reso nance imaging in long-term follow-up of patients (pts) with chronic disease of the thoracic aorta such as coarctation of the aorta, chronic aortic dis section and true aortic aneurysm. A total of 322 magnetic resonance examina tions obtained in 82 pts with chronic disease of the thoracic aorta (31 pts with coarctation of the aorta (CoA), 29 pts with chronic aortic dissection and 22 pts with true aneurysm) over a period of 0.25 to 13.5 (mean +/- SD: 6.5 +/- 3.3) years were retrospectively reviewed. Diameters of the thoraci c aorta were measured at predefined levels and morphological and functional parameters of special interest were analysed in each patient group. Pts we re classified as having constant or progressive disease and clinical end-po ints were defined as (re-)operation or death. 43 pts (52%) (CoA 15 pts, chr onic dissection 16 pts, true aneurysm 12 pts) had constant findings. None o f them underwent (re-)operation and seven patients (16%) died, three of the m from their aortic disease more than five years later after their last mag netic resonance examination, one from an arrhythmogenic event. and in the r emaining 3 pts the cause of death could not be definitely established. 39 p ts (48%,) (CoA 16 pts, chronic dissection 13 pts, true aneurysm 10 pts) had progressive disease as demonstrated by repetitive magnetic resonance imagi ng. Of these 39 pts 24 pts underwent (re-)operation, in 15 pts operation wa s postponed. Four pts died from their aortic disease. Repetitive magnetic r esonance imaging is a clinically feasible technique for long-term follow-up of pts with chronic disease of the thoracic aorta because it can detect pr ogressive disease in a large subset of pts requiring elective surgery. The results of magnetic resonance imaging provided the rationale for either (re -)operation or conservative management, thus guiding patient management. (C ) 2000 Elsevier Science Inc. All rights reserved.