Author + information
- Received March 16, 2011
- Accepted March 24, 2011
- Published online October 4, 2011.
- Andrew C.Y. To, MBChB,
- Karunakaravel Karuppasamy, MBBS, MSc,
- Eric E. Roselli, MD and
- Scott D. Flamm, MD
A 77-year-old man presented with symptomatic calcific aortic stenosis. He had 2 prior bypass surgeries, patent left-sided grafts, collateralized right system, and minimal aortic atherosclerosis. Due to high surgical risk, the surgical team proceeded with an apico-aortic conduit incorporating a porcine stentless aortic bioprosthesis.
Cardiac magnetic resonance imaging post-operatively demonstrated the apico-aortic conduit on 3-dimensional volume-rendered reconstruction (A, Online Video 1). Phase contrast techniques quantified 31% of cardiac output through the native valve supplying the head and upper limbs and 69% through the conduit supplying the lower limbs, with minimal reverse flow in the proximal descending aorta. Steady-state free precession sequences (B, Online Video 2) demonstrated the descending aortic flow pattern. Methodical imaging of the proximal anastomosis (red arrow, C, D, Online Videos 3 and 4) and distal anastomosis (blue arrow, E, F, Online Videos 5 and 6) excluded immediate surgical complications. There was no bioprosthetic regurgitation (yellow arrow, E, F).
Cardiac magnetic resonance imaging is not limited by imaging windows or planes, can quantify blood flow, and therefore is the ideal modality for assessing apico-aortic conduits.
Dr. To acknowledges the support from the Overseas Fellowship Award from the National Heart Foundation of New Zealand.
- Received March 16, 2011.
- Accepted March 24, 2011.
- American College of Cardiology Foundation