Dilatation of Vascular Prostheses in Ascending Aortic Position: A Long-Term Follow-Up Computed Tomography Study with Comparison of Different Measurement Methods

Marwan Hamiko; Matthias Endlich; Christian Krämer; Chris Probst; Armin Welz; Kai Wilhelm; Wolfgang Schiller

doi:10.1055/s-0036-1597116

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2018; 66(03): 206-214
DOI: 10.1055/s-0036-1597116

Original Cardiovascular

Georg Thieme Verlag KG Stuttgart · New York

Dilatation of Vascular Prostheses in Ascending Aortic Position: A Long-Term Follow-Up Computed Tomography Study with Comparison of Different Measurement Methods

Marwan Hamiko

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

,

Matthias Endlich

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

,

Christian Krämer

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

,

Chris Probst

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

,

Armin Welz

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

,

Kai Wilhelm

²Department of Radiology, University of Bonn, Bonn, Germany

,

Wolfgang Schiller

¹Department of Cardiac Surgery, University of Bonn, Bonn, Germany

› Institutsangaben

Abstract

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Abstract

Background The aim of this study was to evaluate long-term dilatation of Hemashield Gold and Hemashield Platinum vascular prostheses in ascending aortic position using different measurement methods to obtain precise results.

Methods Between 1999 and 2007, 73 patients with Stanford type A dissection received ascending aortic replacement with Hemashield Gold and Hemashield Platinum prostheses. Measurements were performed using multiplanar reconstruction mode of electrocardiogram (ECG)-gated, multislice spiral computed tomography (MSCT) in strictly orthogonal cross-sectional planes. Different methods of measurement were compared and maximum dilatation was estimated for different time spans.

Results Diameters calculated from the measured circumference showed a significant (p = 0.037) but clinically not relevant difference (0.1 mm) to the mean between the largest and the shortest cross-sectional diameter of the prosthesis. Dilatation after 24.2 ± 10.2 months was 8.5 ± 4.5%. Long-term dilatation after 91.8 ± 34 months amounted to 11.8 ± 4.2%.

Conclusion Based on ECG-gated MSCT images, the presented methods of measurement provided reliable results. Long-term analysis shows low dilatation rates for Hemashield prostheses, which therefore can be considered as safe from this point of view. Nevertheless, a maximal dilatation of 20% could be relevant in valve sparing root replacement. It remains unclear if a dilatation like this contributes to the formation of suture aneurysms.

Keywords

computed tomography - CT scan - aorta/aortic - vascular graft - aneurysm/dissection - imaging

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Referenzen

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