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Biomedical subjects

R Fattori

Publications and source records attributed to R Fattori.

At least 37 records · Page 2Linked to original sources

Importance of dural ectasia in phenotypic assessment of Marfan's syndrome.

BACKGROUND: Early identification of Marfan's syndrome is fundamental in the prevention of aortic dilatation, but the wide phenotypic expression of the disorder makes the clinical diagnosis very difficult. Dural ectasia has been classified as a major diagnostic criterion; however, its prevalence is not known. We aimed to identify the true prevalence of dural ectasia in Marfan's syndrome, and to investigate its relation to aortic pathology. METHODS: A magnetic-resonance-imaging (MRI) study of the thoracic aorta and of the lumbosacral spine was done in an inclusive series of 83 patients with Marfan's syndrome to assess the presence and degree of dural ectasia and aortic involvement; 12 patients were younger than 18 years. 100 individuals who underwent MRI of the lumbar spine for routine clinical indications represented the control group; none of them had any potential causes for dural ectasia. FINDINGS: Dural ectasia was identified in 76 (92%) patients and none of the control group. The severity of dural ectasia was related to age; the mean (SD) age of patients with mild dural ectasia was 26 years (14) whereas that of those with severe disease (meningocele) was 36 years (9) (p=0.038). 11 of 12 patients younger than 18 years had dural ectasia. No association was found between aortic dilatation and dural ectasia. INTERPRETATION: Dural ectasia is a highly characteristic sign of Marfan's syndrome, even at an early age.

Adolescent↗

Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement.

BACKGROUND: The treatment of thoracic aortic dissection is guided by prognostic and anatomical information. Proximal dissection requires surgery, but the appropriate treatment of distal thoracic aortic dissection has not been determined, because surgery has failed to improve the prognosis. METHODS: We prospectively evaluated the safety and efficacy of elective transluminal endovascular stent-graft insertion in 12 consecutive patients with descending (type B) aortic dissection and compared the results with surgery in 12 matched controls. In all 24 patients, aortic dissection was diagnosed by magnetic resonance angiography. In each group, the dissection involved the aortic arch in 3 patients and the descending thoracic aorta in all 12 patients. With the patient under general anesthesia, either surgical resection was undertaken or a custom-designed endovascular stent-graft was placed by unilateral arteriotomy. RESULTS: Stent-graft placement resulted in no morbidity or mortality, whereas surgery for type B dissection was associated with four deaths (33 percent, P=0.09) and five serious adverse events (42 percent, P=0.04) within 12 months. Transluminal placement of the stent-graft prosthesis was successful in all patients, with no leakage; full expansion of the stents was ensured by balloon inflation at 2 to 3 atm. Sealing of the entry tear was monitored during the procedure by transesophageal ultrasonography and angiography, and thrombosis of the false lumen was confirmed in all 12 patients after a mean of three months by magnetic resonance imaging. There were no deaths or instances of paraplegia, stroke, embolization, side-branch occlusion, or infection in the stent-graft group; nine patients had postimplantation syndrome, with transient elevation of C-reactive protein levels and body temperature plus mild leukocytosis. All the patients who received stent-grafts recovered, as did seven patients who underwent surgery for type B dissection (58 percent) (P=0.04). CONCLUSIONS: These preliminary observations suggest that elective, nonsurgical insertion of an endovascular stent-graft is safe and efficacious in selected patients who have thoracic aortic dissection and for whom surgery is indicated. Endoluminal repair may be useful for interventional reconstruction of thoracic aortic dissection.

Adult↗

MRI of acute and chronic aortic pathology: pre-operative and postoperative evaluation.

With recent advances in the understanding of aortic diseases, both power and versatility have put magnetic resonance imaging (MRI) in the focus of diagnostic work-up in the entire spectrum of clinical aortic pathology. Technical refinements, from classic anatomic imaging to three-dimensional gadolinium-enhanced MR angiography and tissue characterization, have rendered MRI ideal for assessment of acquired disease such as aortic dissection, intramural hematoma, and aneurysm, along with postoperative follow-up evaluation, with better reliability and safety than other imaging modalities. Moreover, congenital pathology of the aorta, including aortic arch anomalies and coarctation, can be non-invasively evaluated by MRI. With spectroscopy and the advent of high-resolution intravascular coils, MRI may even provide histopathologic and potentially prognostic information unparalleled by any other method. J. Magn. Reson. Imaging 1999;10:741-750.

Aorta, Thoracic↗

Composite graft replacement of the ascending aorta: leakage detection with gadolinium-enhanced MR imaging.

PURPOSE: To assess the value of magnetic resonance (MR) imaging in the detection of postoperative complications after composite valve graft replacement. MATERIALS AND METHODS: Spin-echo and gradient-echo MR imaging was performed in 52 patients 1/2 to 200 months after composite graft replacement of the ascending aorta (22 for dissection, 30 for aneurysm). The prosthetic aortic segment, distal and proximal anastomoses, general morphologic characteristics, and diameter of the reimplanted coronary arteries were evaluated. In patients with abnormal perigraft thickening, additional spin-echo imaging was performed after injection of gadopentetate dimeglumine. RESULTS: Normal postoperative perigraft thickening (< or = 10 mm) was observed in 42 patients. Ten patients had abnormal periprosthetic thickening of 15-52 mm. Gadolinium-enhanced MR imaging demonstrated leakage in five of those 10 patients. The lack of enhancement excluded the presence of bleeding in the remaining five patients (three with chronic hematomas, one with infection, and one with granulation tissue). These findings were confirmed at surgery or with subsequent follow-up MR examinations. CONCLUSION: MR imaging was an optimal imaging modality for evaluating the morphologic characteristics of composite grafts and reimplanted coronary arteries. Gadolinium-enhanced MR imaging is a simple, accurate, and noninvasive method for detecting a leak, which necessitates urgent repeat surgery.

Aortic Dissection↗

[Endovascular treatment in diseases of the thoracic aorta].

PURPOSE: To determine whether endovascular treatment of thoracic aorta conditions can be an effective alternative approach to surgical repair. MATERIAL AND METHODS: July 1997 to February 1999, eighteen patients (16 men and 2 women; 58.6 +/- 14.8 years) presenting with different kinds of descending aorta conditions were selected for the endovascular treatment. All patients exhibited severe comorbid pulmonary and/or cardiovascular medical conditions which increased surgical risk. All implants were performed in the operating room under fluoroscopic and TEE guidance. Clinical and imaging follow-up was performed 1, 3, 6 and 12 months later. RESULTS: The endovascular treatment was successful in 17 cases. No deaths or major complications occurred. No leakage was evident at post-procedure angiography. The patients were discharged after 6 +/- 4 days. MRI or CT study performed before hospital discharge showed aneurysms exclusion in 16 patients. In the four cases of dissection, thrombosis of the false lumen was evident since the first follow-up study. In the group of patients (11 cases) with 6 months follow-up, the diameters of stented aortic segments decreased. No late leakage was observed and thrombosis was complete in all cases. DISCUSSION: The natural history of aortic aneurysms and dissection is progressive toward dilation and aortic rupture. Surgery of descending thoracic aorta is burdened with a mortality of 8-12% in elective cases and over 50% in emergency cases or aortic dissection. The endovascular treatment of aortic conditions was introduced in clinical practice in 1991 and literature data show that it is effective, with lower mortality and morbidity rates than surgical treatment. CONCLUSION: Our results stress the feasibility and effectiveness of endovascular procedure in the treatment of complex thoracic aorta conditions even in high risk patients. Thus, endovascular treatment of thoracic aorta can be considered an effective alternative approach to conventional surgery.

Adult↗

Contribution of magnetic resonance imaging in the differential diagnosis of cardiac amyloidosis and symmetric hypertrophic cardiomyopathy.

BACKGROUND: Magnetic resonance imaging (MRI) provides a high-resolution study of atrial and ventricular myocardium depicting morphologic alterations in cardiomyopathies. Furthermore, in systemic amyloidosis, MRI demonstrates the capability to detect amyloid protein by tissue characterization. The aim of this study was to evaluate the potential of MRI in the diagnosis of cardiac amyloidosis. METHODS: MRI was performed in 16 patients with cardiac amyloidosis and in 10 patients with symmetric hypertrophic cardiomyopathy. Myocardial ventricular and atrial thickness (septum, posterior, and lateral wall), right and left ventricular diastolic diameter, and atrial surface were compared. Ventricular myocardium signal intensity was then evaluated by sequences with an echo time (TE) of 20 and 60 ms as the expression of myocardial texture modification. RESULTS: Significant morphologic differences between cardiac amyloidosis and hypertrophic cardiomyopathy were found in the right atrium surface (21.9 vs 17.2 cm2, respectively; P = .05), myocardial thickness of right atrial wall (9.3 vs 4.9 mm; P < .0001 ), and right ventricular free wall (10.6 vs 8.9 mm; P = .011 ). No significant differences were found in the interventricular septum (16.6 vs 17.8 mm), left ventricular posterior wall (18.2 vs 18.8 mm), and left atrial surface (17.4 vs 17.2 cm2). The signal intensity of cardiac amyloidosis was significantly lower with both TE 20 and TE 60 in comparison with hypertrophic cardiomyopathy and to a group of healthy volunteers. CONCLUSIONS: MRI has a potential role in the noninvasive diagnosis of cardiac amyloidosis identifying typical morphologic markers and suggesting the presence of infiltrative disease by tissue characterization.

Adult↗

Surgical indications and timing of repair of traumatic ruptures of the thoracic aorta.

BACKGROUND: The outcome of patients with acute traumatic rupture of the thoracic aorta after motor vehicle accidents is strongly conditioned by injuries to other districts. The timing of repair is controversial when the patients arrive alive to the hospital. METHODS: A series of 42 patients with acute traumatic rupture of the thoracic aorta observed between January 1980 and June 1996 was divided into two groups: group I underwent immediate repair (21 patients) and in group II operation was performed after intensive medical treatment and management of the associated lesions and monitoring of the aortic tear. RESULTS: The mortality in group I patients was 19% and the morbidity was more significant than in group II where no deaths were reported and complications were minor. CONCLUSIONS: Patients with acute traumatic rupture of the thoracic aorta may have a better fighting chance if aortic operation is postponed to the most favorable moment after undergoing life-sustaining measures and management of the major associated lesions. Needless to say, evolution should be closely monitored by computed tomographic scans and magnetic resonance imaging.

Accidents, Traffic↗

Evolution of post-traumatic aortic aneurysm in the subacute phase: magnetic resonance imaging follow-up as a support of the surgical timing.

OBJECTIVES: A recent surgical series documented that in traumatic aortic rupture (TAR) a surgical repair postponed to the treatment of associated lesions reduced operative and overall mortality. Nevertheless some isolated cases may develop to free rupture. Until now, no imaging follow-up studies of post-traumatic aortic lesions have been reported in the early stage. The aim of this study is to analyze the behaviour of traumatic aortic ruptures in the subacute phase, in order to detect the morphological characteristics of unstable post-traumatic aneurysms. METHODS: Twenty-five consecutive patients affected by traumatic aortic rupture (one intimal hemorrhage, 19 partial lesions and five circumferential lesions) were admitted to the department of cardiac surgery. Magnetic resonance imaging (MRI) was the imaging method used to confirm the diagnosis. No one was operated on during the acute phase. All patients were treated with beta-blockers and vasodilators as well as limited fluid administration. Delayed surgery was carried out in 18 patients at 243 days (+/-127), after the resolution of associated lesions. A scheduled MRI follow-up was performed at 7, 15 and 30 days and immediately before the operation. The parameters examined were increase of post-traumatic aneurysm, increase of periaortic hematoma and modification of the thoracic associated lesions. RESULTS: At 30 days a 3.0 +/- 3.7 mm median increase of the aneurysm was observed, while in the subsequent period the lesions became substantially stable, resulting in a 4.4 +/- 3.6 mm increment at the end of the follow-up. The circumferential lesions presented a higher increment with respect to the partial lesions. In three cases an augmentation of 6, 7 and 12 mm was detected and surgical repair was anticipated. In 13 cases a periadventitial hematoma surrounding the aortic aneurysm decreased through the time. One case of intimal hemorrhage healed spontaneously, with no aneurysm formation. Thoracic associated lesions (pleural and pericardial effusions, rib fractures, lung focal contusions and two cases of ARDS) resolved at 30-60 days. CONCLUSIONS: Despite common knowledge, considering TAR highly evolutive in the acute and subacute phase, this study demonstrated that this pathological entity is relatively stable if a proper pharmacological treatment is administrated. MRI follow-up is recommended in order to detect isolated cases of unstable aneurysm.

Aorta, Thoracic↗

Intramural posttraumatic hematoma of the ascending aorta in a patient with a double aortic arch.

We report a case of posttraumatic intramural hematoma (IMH) of the ascending aorta in a patient with a double aortic arch and coronary artery disease. This unusual and asymptomatic finding came to our observation because the patient presented an acute myocardial infarction and underwent coronary angiography. The diagnosis was performed by magnetic resonance imaging (MRI) which defined well the anatomy of aorta and showed the characteristics of the hematoma. The data were useful in planning the surgical repair.

Accidents, Traffic↗

[The surgical treatment of a rare primary cardiac tumor: hemangioma. A report of 2 cases].

Primary benign tumors of the heart are particularly rare; cardiac hemangioma is one of the most rare primary benign cardiac tumors. Natural history, symptoms and prognosis of the disease depend on the potential complications due to the location and diffusion of the mass. We report on 2 cases of cardiac hemangioma, diagnosed occasionally in the first patient or due to gastroenteric symptoms in the second patient. The diagnosis was obtained by 2-D-echo and magnetic resonance imaging. In both cases the hemangioma was located on the right ventricle. Both patients underwent tumor resection in hypothermic cardiopulmonary bypass. In one case, a graft to the right coronary artery was associated; in the other case, the right ventricular outflow tract was reconstructed with an infundibular patch. Histology showed mixed hemangioma in one case and cavernous hemangioma in the other. The postoperative course was uneventful. At a follow-up of 8 years and 1 year, respectively, both patients are classified as NYHA 1 and both 2-D-echo and magnetic resonance imaging did not show any residual tumoral mass. This experience demonstrates that, depending on their location, benign neoplastic masses may be radically resected with acceptable operatory risks and excellent long-term results.

Aged↗

Delayed surgery of traumatic aortic rupture. Role of magnetic resonance imaging.

BACKGROUND: Traumatic aortic rupture (TAR) is a pathological entity with a high mortality, both spontaneous and perioperative. Delayed surgical repair has been proposed when associated lesions are stabilized. The aim of this study was to validate MRI for detecting both the presence and type of TAR and to monitor posttraumatic aneurysm and associated lesions. METHODS AND RESULTS: Twenty-four consecutive patients with acute chest trauma and suspected aortic rupture, as suggested by emergency CT or chest radiographs, were subjected to MRI and/or angiography in random order. Such parameters as the presence and type of lesion; presence of periaortic, pericardial, mediastinal, or pleural effusion; and presence of associated lesions were considered in every patient. Follow-up imaging was performed exclusively by MRI every 1 to 2 months. TAR was present in 20 patients. No patient underwent surgery in the acute phase; 14 patients underwent surgery at 6.8 +/- 2.7 months; 5 are waiting for surgery; and 1 healed spontaneously. There was no overall mortality. For detection of TAR, the accuracy of MRI was 100%; angiography, 84%; and CT, 69%. In detecting the type of lesion, the diagnostic accuracy of MRI was 92%. During follow-up, a significant increase in the posttraumatic aneurysm was observed in 2 patients, and surgical repair was initiated. CONCLUSIONS: In chest trauma patients, MRI provides complete anatomic data to assess the severity of aortic and thoracic lesions. Moreover, along with the concept of delayed surgical repair of TAR, MRI is the ideal modality to monitor and follow TAR before surgical repair.

Adolescent↗

[Diagnostic contribution of magnetic resonance in clinically suspected arrhythmogenic dysplasia of the right ventricle].

BACKGROUNDS: Magnetic Resonance (MR) imaging gives information about the complex anatomy of the right ventricle (RV). Because of the capability of tissue characterization, in addition to the functional and morphologic analysis, MR imaging is an optimal technique to investigate patients (pts) with clinical suspicion of arrhythmogenic right ventricular dysplasia (ARVD). METHODS: The purpose of the current study was to investigate a group of 55 pts with ventricular arrhythmias in order to detect ARVD. MR was performed with a 0.5 magnet (MR MAX PLUS G:E. Medical System). Electrocardiographically gated spin-echo and gradient-echo MR images of the heart were obtained in both transverse and sagittal planes. Sustained ventricular tachycardia (SVT) was present in 14 pts, non sustained ventricular tachycardia (NSVT) in 13 pts, left bundle block ventricular premature complexes > 10000/24 h (VPC/LBB) in 28 pts. The abnormalities analyzed were: presence of focal or diffuse fatty replacement of myocardium, segmental or global dilation of the RV, reduction of ejection fraction with akinetic or dyskinetic areas, disarrangement of the trabecular pattern with the hypertrophy of the moderator band. RESULTS: When intramyocardial fatty replacement and at least two of the abnormalities were present we considered the MR aspects compatible with the diagnosis of ARVD. We detected the presence of ARVD in 8/14 pts with SVT, in 4/13 pts with NSVT, in 4/28 pts VPC/LBB: In 10/16 pts with ARVD left ventricular abnormalities (areas of fatty replacement of the myocardial wall and/or reduction of ejection fraction) were also present. The left ventricular involvement was detected in 5 pts with SVT, in 2 pts with NSVT, in 3 pts with VPC/LBB: Even if in 31 pts it was not possible to identify aspects compatible with the diagnosis of ARVD, some structural abnormalities of RV were also present. Because of its non-invasiveness MR is an excellent technique for the detection of ARVD, and of minor right ventricular abnormalities.

Adult↗

Iomeprol and iopamidol in cardiac angiography: a randomised, double-blind, parallel-group comparison.

During cardiac angiography, hemodynamic alterations and surface electrocardiographic changes are common, predictable and dose-related adverse reactions to radiocontrast media. High osmolality, inadequate sodium content and local transient hypocalcemia are thought to be the main mechanisms responsible for these untoward cardiovascular effects. The purpose of this double-blind, parallel-group trial was to compare the hemodynamic and electrocardiographic responses to cardiac and selective coronary artery injection of iomeprol 400 (400 mgI/ml) and iopamidol 370 (370 mgI/ml). One-hundred consenting adult inpatients were randomised to receive iomeprol 400 (41 males, nine females; mean age, 56.6 years) or iopamidol 370 (46 males, four females; mean age, 57.6 years). Both agents produced minor and transient hemodynamic and electrophysiological effects. Following left ventriculography, iopamidol 370 produced a significantly greater increase in LVEDP than iomeprol 400 (mean increases after first and second left ventriculogram: 2.5 and 4.6 mmHg with iomeprol 400, 3.3 and 9.9 mmHg with iopamidol 370, P = 0.027). The QT-interval was more affected by iopamidol 370 than by iomeprol 400. However, post-contrast prolongation of the QT-interval was not significant with either agent, nor were there any significant T-wave, ST-segment or RR-interval changes associated with the injection of the test compounds. No serious adverse events occurred throughout the study. Mild pain was complained by only one patient, while most patients reported mild to moderate sensation of heat. Image quality of the vast majority of the procedures was rated as good or excellent in both patient groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Angioplasty in patients already treated with aortocoronary bypass: immediate and short-term results].

Percutaneous transluminal coronary angioplasty (PTCA) is performed in patients with prior aortocoronary bypass grafting (CABG) with good results in native vessels and in the coronary graft anastomoses, but with high percentage of restenosis in the body and in the proximal portion of the grafts. The use of intracoronary stents is now spreading, their implantation can improve the immediate outcome and may decrease the incidence of restenosis, mostly in the body of the graft. In order to evaluate PTCA in CABG patients as to numbers and short-term results, the data regarding the year 1993 of 10 Italian Centers are presented. In these Centers 3,519 PTCA were performed, 233 (6.6%) of which on CABG patients. PTCA has been performed in native vessels in 136 patients and in CABG in 126 patients, with 29 patients treated in native vessels as well as in CABG. An angiographic and clinical success was obtained in 215 patients (92%). A major complication occurred in 11 (4.7%) patients with 8 (3.4%) myocardial infarctions, and 3 (1.3%) deaths. Forty-five (19.3%) stents were implanted with considerable differences among the Centers. One hundred seventy-three patients were followed up for 6 months: 110 (63.6%) were asymptomatic and 57 (32.9%) had complained angina; 27 (15.6%) had a second PTCA and 6 (3.5%) had CABG surgery; 1 patient (0.6%) suffered a myocardial infarction and 7 (4%) died (3 due to CABG reinterventions). To evaluate the long-term follow-up, data regarding 58 patients submitted to PTCA in the Institute of Cardiology of Bologna since 1985 to 1993 are showed, with a 3-year follow-up (36 +/- 26 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗

[The role of magnetic resonance in studying hypertrophic cardiomyopathy: the echocardiographic correlations and clinical implications].

Clinical studies evaluating the role of magnetic resonance imaging (MRI) in patients with hypertrophic cardiomyopathy are scanty. To assess the capability of MRI to define the presence, distribution and severity of left ventricular hypertrophy, the prevalence and clinical implications of right ventricular hypertrophy, the prevalence and clinical implications of myocardial structural abnormalities, MRI and echocardiography were performed in 37 unselected patients (age 10-72 years, mean 38 +/- 19) with hypertrophic cardiomyopathy. The concordance between the two methods was 100% in the diagnosis and classification of left ventricular hypertrophy as asymmetric, concentric or apical. A significant linear correlation was found between echocardiography and MRI measurements of interventricular septum (r = 0.69, p < 0.0001, SEE = 4) and left ventricular posterior wall (r = 0.67, p < 0.0001, SEE = 2.4). Right ventricular hypertrophy (right anterior wall diastolic thickness > 5 mm) was disclosed by MRI in 23/33 patients (70%). In this group, left posterior wall thickness and left atrial diameter were higher (15 +/- 4 versus 11 +/- 2 mm, p < 0.01 and 45 +/- 9 versus 38 +/- 5 mm, p < 0.05 respectively). On T2 weighted sequences, areas of reduction of signal intensity, probably caused by myocardial fibrosis, were detected in 16 cases (43%). This group was characterized by a higher value in maximal septal thickness (26 +/- 7 versus 21 +/- 6 mm, p < 0.05) and in maximal left posterior wall thickness (15 +/- 9 versus 7 +/- 8 mm, p < 0.01). All the 3 cases with dilated and hypokinetic left ventricle showed this type of tissue abnormality.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Role of transesophageal echography in the diagnosis of aortic dissection and in therapy programming].

The diagnostic accuracy of transesophageal echocardiography and its relevance on the decision making process were evaluated in 80 patients with suspected aortic dissection during a 37-month period. The diagnosis was proven by aortography and/or magnetic resonance and/or computerized tomography and/or surgery and/or autopsy in each case. Transesophageal echocardiography had no serious complication. A correct diagnosis of aortic dissection was made in 39 of 40 patients (sensitivity, 97.5%; specificity, 100%) and the type of dissection was correctly demonstrated in each case. Thrombi in the false lumen were detected in 16 patients. The primary entry site was correctly identified in 33 patients (85%). Aortic regurgitation was detected in 25 cases (severe in 9) and pericardial effusion in 14 (with tamponade in 2). Transesophageal echocardiography was more accurate than aortography in the diagnosis of noncommunicating intramural dissection (2 cases) and identified more precisely the retrograde extension of the dissection in DeBakey type III patients (4 cases). In 9 cases surgical indication was based on clinical data and transesophageal echocardiography alone. We conclude that transesophageal echocardiography allows a bedside, safe and accurate diagnosis of aortic dissection. In the majority of the patients it provides the minimal diagnostic information necessary to the therapeutical decision making.

Acute Disease↗

[Role of magnetic resonance in the follow-up of surgically treated aortic dissection].

Twenty-one patients were examined with MRI 0.5 to 200 months after surgical aortic dissection. The series included 15 type-I dissections, 1 type-II dissection and 5 complicated type-III dissections. MR images demonstrated the persistence of the intimal flap with patency of both the true and the false lumen in 17 cases, the complete obliteration of the false lumen in 1 case and the partial thrombosis of the false lumen in 3 cases. Coronary artery ostial reimplantation was depicted in all the patients who underwent this kind of surgery; in 1 case, a small hematoma was present at the site of reimplantation. In 3 patients, an organized hematoma was seen between the prosthetic graft and the native aortic wall; in 1 case the aortic lumen was markedly reduced, while in the extant 2 cases, signal intensity features were suggestive of subacute hematoma due to prosthetic graft degeneration. Seven patients underwent two MR exams: the first one immediately after surgery (in most cases) and the second one at 3-11 months. Aortic diameter progressively increased in 4 patients, 3 of them with Marfan syndrome. In conclusion, MRI proved an accurate technique to assess aortic size beyond the prosthetic graft and to demonstrate the residual dissecting process and the postoperative problems in the prosthetic conduit.

Adult↗