Abstract
Object
Aortic valve bypass is a technique used in high-risk patients with critical aortic stenosis that consists of placement of a conduit from the left ventricular apex to descending aorta. We describe the imaging appearances of this apicoaortic conduit on multidetector CT (MDCT).
Methods
Each patient underwent retrospective ECG-gated MDCT using a 16-detector-row scanner several days after placement of an apicoaortic conduit. All images were assessed by two radiologists who reviewed the appearance of the apicoaortic conduit and any post-operative complications. Follow-up studies were available for several patients.
Results
Twelve patients (9 men, 3 women, mean age - 78 years) underwent evaluation and the conduit was visible in each. The valve within the conduit was visible in ten (91%) of the 11 patients who received intravenous contrast material. Common findings were periconduit outpouching and hypoperfusion involving the left ventricle. Complications included pericardial hemorrhage, hemothorax and ventricular pseudoaneurysm. Mild to moderate increase in wall thinning was identified in the three patients who underwent follow-up imaging.
Conclusion
Aortic valve bypass with an apicoaortic conduit appears to be a feasible alternative to aortic valve replacement in high-risk patients. MDCT is an excellent method to assess the imaging features of such conduits.
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References
Gammie JS, Brown JW, Brown JM et al. (2006) Aortic valve bypass for the high-risk patient with aortic stenosis. Ann Thorac Surg 81:1605–1610
Carrel A (1910) On the experimental surgery of the thoracic aorta and heart. Ann Surg 52:83–95
Sarnoff SJ, Donovan TJ, Case RB (1955) The surgical relief of aortic stenosis by means of apical-aortic valvular anastomosis. Circulation 11(4):564–575
Sweeney MS, Walker WE, Cooley DA, Reul GJ (1986) Apicoaortic conduits for complex left ventricular outflow obstruction: 10-year experience. Ann Thorac Surg 42:609–611
Cooley DA, Lopez RM, Absi TS (2000) Apicoaortic conduit for left ventricular outflow tract obstruction: revisited. Ann Thorac Surg 69:1511–1514
Renzulli A, Gregorio R, De Feo M, Ismeno G, Covino FE, Cotrufo M (2000) Long-term results of apico-aortic valved conduit for severe idiopathic hypertrophic subaortic stenosis. Tex Heart Inst J 27(1):24–28
Vassiliades TA Jr (2003) Off-pump apicoaortic conduit insertion for high-risk patients with aortic stenosis. Eur J Cardiothorac Surg 23:156–158
Cannon CM, Francken GA, Knechtges TE (1994) Appearance of left ventricular apicoaortic valved conduit on chest radiographs. AJR Am J Roentgenol 162:730–731
Schoenhagen P, Halliburton SS, Stillman AE, et al. (2004) Noninvasive imaging of coronary arteries: current and future role of multi-detector row CT. Radiology 232:7–17
Schoepf UJ, Becker CR, Ohnesorge BM, Yucel EK (2004) CT of coronary artery disease. Radiology 232:18–37
Stanford W (2005) Advances in cardiovascular CT imaging: CT clinical imaging. Int J Cardiovasc Imaging 21:29–37
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White, C.S., Jeudy, J., Read, K. et al. Aortic valve bypass for aortic stenosis: imaging appearances on multidetector CT. Int J Cardiovasc Imaging 23, 281–285 (2007). https://doi.org/10.1007/s10554-006-9131-6
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DOI: https://doi.org/10.1007/s10554-006-9131-6