IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Computed Tomography Finding Mimicking Aortic Dissection After Cabrol Procedure
Tim J Kruser, MD,
Satoru Osaki, MD,
Takushi Kohmoto, MD,
Paramjeet S Chopra, MD
Cardiothoracic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA
Satoru Osaki, MD, Tel: +1 608 263 4071, Fax: +1 608 263 0547, Email: osaki{at}surgery.wisc.edu, Division of Cardiothoracic Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3236, USA.
A 64-year-old man underwent aortic valve replacement. He did well for 18 months then presented with increasing fatigue and was noted to have an aortic regurgitation murmur. An echocardiogram demonstrated moderate perivalvular leakage and enlargement of the ascending aorta. He underwent successful aortic root replacement. Because of dense adhesions, it was difficult to mobilize the left main coronary to do a modified Bentall operation, so we elected to do a modified Cabrol procedure with a 10-mm graft anastomosed end-to-end fashion to the left coronary artery and end-to-side to the right anterolateral aspect of the valve conduit. The right coronary button was easily anastomosed end-to-side to the anterior aspect of this conduit, without tension. A follow-up computed tomography scan after 3 years was interpreted by the primary physician as chronic aortic dissection. However, careful review, along with the patient’s surgical history, indicated that the images represented an intact interposition tube graft after the modified Cabrol procedure (Figure 1
).
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Figure 1. Axial computed tomography: (A) end-to-side anastomosis of modified Cabrol conduit with ascending aortic graft (arrow), (B & C) Cabrol conduit situated to right of ascending aortic graft (arrowhead) and wrapped into native aortic wall (arrowhead), (D) anastomosis of Cabrol conduit with left coronary artery (arrow). AAG ascending aortic graft, PA pulmonary artery, DA descending aorta, SVC superior vena cava.
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Asian Cardiovasc Thorac Ann 2009;
17:108-109
© 2009 by SAGE Publications
DOI: 10.1177/0218492309102454
