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. 2016 Jun 1;11(1):89.
doi: 10.1186/s13019-016-0487-y.

Computed tomography angiography of aorta subjected to external wrapping

Tomasz Płonek  1 , Andrzej Dumanski  2 , Rafal Nowicki  2 , Wojciech Kustrzycki  2
Affiliations

Computed tomography angiography of aorta subjected to external wrapping

Tomasz Płonek et al. J Cardiothorac Surg. .

Abstract

Background: External wrapping is a surgical technique used in patients with dilated ascending aorta. To date, there is no available data describing the radiographic features of the aorta subjected to external wrapping using a straight corrugated Dacron vascular prosthesis. The aim of this study was to find distinctive radiographic features of an externally constricted aorta.

Methods: Preoperative and early postoperative (7th postoperative day) CT angiography images of ten patients who underwent wrapping procedures were assessed and compared. The images were analyzed in order to find characteristic features of CT angiography images of the ascending aorta subjected to external wrapping.

Results: The CT-angiography images showed that the aortic wall deformed significantly (the wall plicated) after the wrapping procedure in one patient, whose aortic diameter was decreased by 47 %. The remaining nine patients did not have significant aortic wall deformations. All patients presented with a periaortic mass. This was a collection of blood clots and pericardial fluid that filled the empty space in the pericardium following a decrease in the diameter of the ascending aorta. A very thin (<1 mm) crescent-shaped uncontrasted layer was noticed between the aorta and the periaortic area in all patients. This, in turn, was an empty space between the aorta and the corrugated vascular prosthesis.

Conclusions: The CT-angiography images of the aorta subjected to external wrapping may have unique features that are not observed after other operations on the ascending aorta. The knowledge about the details of this surgical procedure helps to correctly assess these images.

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Figures

Fig. 1
Fig. 1
Preoperative (left) and postoperative (right) photos of the aorta being wrapped with a Dacron vascular prosthesis. 1 – aorta, 2 – venous cannula for the heart-lung machine placed in the right atrial appendage, 3 – arterial cannula for the heart-lung machine placed in the proximal aortic arch, 4 – pericardial sac, 5 – pulmonary trunk, 6 – right ventricle, 7 – wrapped aorta, 8 – right atrium
Fig. 2
Fig. 2
Preoperative and postoperative angio-CT images of patients who underwent the wrapping procedures. Red arrows point toward the uncontrasted layer between the vascular prosthesis and the aortic wall
Fig. 3
Fig. 3
A comparison of preoperative and postoperative angio-CT images of a patient whose aorta was decreased by 47 %. Red arrows point at the sites of plication of the aortic wall
See this image and copyright information in PMC

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