Upward Displacement of Prosthetic Aortic Valved Conduit after Modified Bentall Procedure for Type A Acute Aortic Dissection
Massimiliano Sperandio
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Tor Vergata University, Roma, Italy
Francesca Nicolò
Operative Unit of Cardiac Surgery, Tor Vergata University, Roma, Italy
Armando Fusco
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Tor Vergata University, Roma, Italy.
Emanuele Bovio
Operative Unit of Cardiac Surgery, Tor Vergata University, Roma, Italy
Mario Raguso *
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Tor Vergata University, Roma, Italy
Giovanni Simonetti
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Tor Vergata University, Roma, Italy
*Author to whom correspondence should be addressed.
Abstract
Aim: Role of non-invasive coronary artery computed tomography (CACT) in diagnosis of complications of aortic root surgery in patients with chest pain.
Introduction: Dehiscence of an aortic valved conduit or pseudoaneurysm development is a rare, but serious and potentially life-threatening complication after aortic root surgery.
Case Presentation: We report an interesting case of a 61-year-old man with chest pain and dyspnea, previous history of modified Bentall procedure for type A acute aortic dissection and coronary stenting, that shows a complete detachment and upward displacement of a composite tubular graft with mechanical valve prosthesis detected by a CACT angiography.
Discussion: Generally, in the few survivors, the diagnosis is made by means of echocardiography. This is the first case of CACT diagnosis of a prosthetic aortic valved conduit displacement after a modified Bentall procedure for type A acute aortic dissection. With the use of this imaging technique was possible a complete evaluation of the coronary stents and the native coronary arteries, avoiding the coronary artery angiography that adds an elevation of the risk for this kind of patients.
Conclusion: In symptomatic patients with a previous history of treated aortic dissection and coronary artery disease without evidence of recurrent ischemia, the CACT angiography can be considered a good diagnostic option. It provides detailed informations about the coronary arteries and the aorta allowing an accurate diagnosis.
Keywords: Computed tomography angiography, echocardiography, Bentall procedure, prosthetic aortic valve, aortic conduit, dehiscence, displacement