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Biomedical subjects

G Hudon

Publications and source records attributed to G Hudon.

At least 19 recordsLinked to original sources

Measurement of odor intensity by an electronic nose.

The possibility of using electronic noses (ENs) to measure odor intensity was investigated in this study. Two commercially available ENs, an Aromascan A32S with conducting polymer sensors and an Alpha M.O.S. Fox 3000 with metal oxide sensors, as well as an experimental EN made of Taguchi-type tin oxide sensors, were used in the experiments. Odor intensity measurement by sensory analysis and EN sensor response were obtained for samples of odorous compounds (n-butanol, CH3COCH3, and C2H5SH) and for binary mixtures of odorous compounds (n-butanol and CH3COCH3). Linear regression analysis and artificial neural networks (ANN) were used to establish a relationship between odor intensity and EN sensor responses. The results, suggest that large differences in sensor response to samples of equivalent odor intensity exist and that sensitivity to odorous compounds varies according to the type of sensors. A linear relationship between odor intensity and averaged sensor response was found to be appropriate for the EN based on conducting polymer sensors with a correlation coefficient (r) of 0.94 between calculated and measured odor intensity. However, the linear regression approach was shown to be inadequate for both ENs, which included metal oxide-type sensors. Very strong correlation (r = 0.99) between measured odor intensity and calculated odor intensity using the ANN developed were obtained for both commercial ENs. A weaker correlation (r = 0.84) was found for the experimental instrument, suggesting an insufficient number of sensors and/or not enough diversity in sensor responses. The results demonstrated the ability of ENs to measure odor intensity associated with simple mixtures of odorous compounds and suggest that ANN are appropriate to model the relationship between odor intensity measurement and EN sensor response.

Air Pollution↗

Early and long-term results of percutaneous transluminal angioplasty of the lower abdominal aorta.

PURPOSE: The purpose of this study was to determine the early and long-term results of percutaneous transluminal angioplasty (PTA) of atherosclerotic lower abdominal aorta stenosis. METHODS: This study was performed as a retrospective study. From 1980 to 1997, 46 patients with chronic lower limb ischemia with moderate to severe claudication as the result of isolated infrarenal disease or aortoiliac disease underwent PTA. All patients underwent angiography before and after angioplasty and Doppler ultrasound scan examination with ankle-brachial index determination. No stents were used. RESULTS: The technical success rate was 96% (44 of 46 cases). Thirty-eight patients (83%) immediately showed clinical, hemodynamic, and angiographic improvement. The initial success rate for patients with isolated infrarenal or bifurcation disease was 92%, whereas it was 71% for aortoiliac disease. Among the eight patients with no initial improvement, four had clinical deterioration and two required emergency surgical revascularization. There were no other complications. Fifty-six percent of the patient conditions (95% confidence interval [CI], 38% to 74%) remained clinically improved at the 5-year follow-up examination. Recurrence of symptoms was caused by femoropopliteal disease in most patients. The primary patency rate assumed with maintenance of hemodynamic improvements was 70% (95% CI, 52% to 88%) and 64% (95% CI, 44% to 84%) at 4 and 5 years of follow-up, respectively. The primary patency rate at 4 years for patients with isolated infrarenal or bifurcation disease was 83% (95% CI, 64% to 100%), whereas it was 55% for aortoiliac disease (95% CI, 30% to 80%; P =.06) The variables that were statistically predictive of patency failure were poor runoff (P =. 01) and presence of aortoiliac atherosclerotic disease (P =.04). CONCLUSION: Our results suggest that PTA is an excellent treatment for chronic arterial insufficiency of the lower extremities as the result of isolated atherosclerotic lower abdominal aortic occlusive lesions because of good long-term patency. Aortic PTA for those patients with iliac involvement or with poor runoff gives acceptable results but carries lower patency and clinical success rates.

Adult↗

Post-traumatic thoracic pseudoaneurysm repair with an endoluminal expandable stent.

Recent technological improvement has allowed endoluminal correction of thoracic and abdominal aortic aneurysm through percutaneous insertion of expandable stents. A woman who presented with chronic pseudoaneurysm of the thoracic aorta 10 years after being in a car accident is presented. A Talent stent was introduced through the femoral artery and successfully deployed under fluoroscopic guidance across the aneurysmal defect. Recovery was uneventful, and 12 months later the patient remained asymptomatic.

Accidents, Traffic↗

Comparison of ionic and nonionic low osmolar contrast media in relation to thrombotic complications of angioplasty in patients with unstable angina.

BACKGROUND: Acute complications of percutaneous transluminal coronary angioplasty (PTCA) are more common in patients with unstable coronary syndromes. The objective of this study was to prospectively determine the differences between ionic and nonionic low osmolar contrast media (LOCM) on potential risk of acute complications, particularly abrupt vessel closure, in patients with unstable angina undergoing PTCA. METHODS: A total of 210 patients with 278 lesions were randomized to receive either ionic or nonionic LOCM during PTCA. Quantitative coronary angiographic measurements and assessment of filling defects were made by experienced observers who were blinded to the type of contrast media used. RESULTS: The baseline clinical and angiographic characteristics, the immediate postangioplasty results, and clinical outcome were similar in both groups. Subacute recoil, defined as the difference between minimal luminal diameter (in millimeters) at 0 and 15 minutes after angioplasty, was significantly greater in patients receiving nonionic LOCM (0.17 +/- 0.36 mm vs 0.07 +/- 0.18 mm, p = 0.004). A filling defect abnormality attributable to dissection, thrombus, or a combination of the two was noted in similar proportions of the two groups. Although nonsignificant, more thrombus was noted in the nonionic group (21 of 129 vs 15 of 141, p = NS). The abrupt vessel closure rate was similar in the two groups and was only 1.9% in the first 24 hours. However, 17 (8.3%) patients had a repeat PTCA at 15 minutes (9 ionic vs 8 nonionic). CONCLUSION: In patients with unstable angina the choice of ionic or nonionic LOCM does not appear to significantly affect the clinical outcome of PTCA.

Adult↗

Coronary endarterectomy revisited: mid-term angiographic results.

OBJECTIVES: To evaluate the value of concomitant coronary endarterectomy (CE) in the modern era of coronary revascularization. METHODS: Retrospective study. Twenty-eight patients (five women; 23 men) who underwent coronary endarterectomy were angiographically studied 24 +/- 22 months after the procedure. Necessity CE (vessel completely occluded or with lumen less than 1 mm) was performed on the left anterior descending (LAD) artery in 12 patients, the right coronary artery (RCA) in nine, the obtuse marginal artery (OM) in five and a diagonal branch in two patients. Conduits used for revascularization were the internal thoracic artery (ITA) in 11 (all anastomosed to the LAD; combined with saphenous vein patch in four) and a saphenous vein graft in 17 patients. Mean atherosclerotic core length was 3.3 +/- 1.8 cm. An average of 3.1 +/- 0.7 distal anastomoses per patient were constructed, with mean aortic cross-clamp and cardiopulmonary bypass times of 61.2 +/- 20.2 mins and 94.0 +/- 23.5 mins, respectively. RESULTS: Overall, angiographic patency rate was 71% (20 of 28) for the endarterectomized vessels (12 of 12 LAD, six of nine RCA, two of five OM and none of two diagonal arteries) and 93% (57 of 61) for the nonendarterectomized vessels. Among the eight patients with occluded CE vessels, two sustained a perioperative myocardial infarction, five developed angina during follow-up, and one patient remained asymptomatic. CONCLUSION: Necessity CE demonstrates acceptable mid-term patency. In addition, this study showed excellent patency following CE of the LAD revascularized with the ITA, with or without only a saphenous vein patch.

Aged↗

Retrograde replacement of the thoracic aorta under circulatory arrest and retrograde cerebral perfusion.

Single-stage replacement of the ascending, transverse and descending thoracic aorta remains a noteworthy surgical intervention associated with significant morbidity. Aside from the surgical aspects, brain preservation during the circulatory arrest period, which is generally needed to perform the procedure, is a constant preoccupation for the surgeon. A 43-year-old man had an extensive thoracic aneurysm 4 years after an initial type A aortic dissection involving the entire thoracic aorta. The Cooley technique of retrograde replacement of the thoracic aorta was performed along with retrograde cerebral perfusion. The combined sternal and thoracic approach suggested for this technique provided excellent exposure and, despite a circulatory arrest time of 88 minutes, the patient's cognitive abilities were found to be well preserved at follow-up 2 months after the surgery, indicating the efficacy of the cerebral retrograde perfusion. The authors conclude that retrograde replacement of the thoracic aorta combined with cerebral retrograde perfusion are convenient procedures that allow extensive aortic replacement without brain damage.

Adult↗

Mycotic aneurysm of the palmar arch after endocarditis.

Mycotic pseudoaneurysms of upper extremities are an infrequent complication of endocarditis. We describe a case of mycotic pseudoaneurysm of the superficial palmar arch in a patient who had acute bacterial endocarditis. We discuss operative and pathologic findings and briefly review the literature on the subject.

Aged↗

Permanent Electronic Storage of Angiographic Images in the Catheterization Laboratory: High-Resolution and Real-Time Acquisition on Optical Laserdiscs.

The use of electronic ÒfilmlessÓ media for long-term archiving of coronary angiograms has been impeded by the problems of image storage and data transfer among institutions. Although long-term analogue storage of the images is presently feasible, and much less costly than digital storage, processing has been limited to a 625 lines video format, not optimal for high quality images. We developed a bi-directional 1249/625 lines converter, able to store and to replay high resolution (1249 lines) video images, from Component Record Video (CRV) Optical Laser (Analogue) Videodisks. Image quality and medical relevance were evaluated five ways: 1) Outside experts compared 593 static images stored on CRV discs to the same images stored in a high-resolution digital format blinded to source of image. The four experts found no visual or medical difference in 98% of evaluated images and minor differences in the remainder. The differences in the remaining images were not consistent among experts. 2) Two of the experts also compared the enhanced CRV optically stored image to the image obtained on simultaneously recorded 35mm cine film, and found the enhanced CRV stored image to be superior or similar, but never inferior to the film image. 3) 90 representatives from 63 outside institutions compared images from both a digital hard drive and the enhanced CRV optical (analogue) storage displayed at a Windows based digital workstation. During the test they were blinded as to the source of the images. The representatives found no difference in image resolution, quality, diagnostic accuracy, and medical relevance. 4) We evaluated quantitative coronary angiography (QCA) on standard coronary test phantoms using enhanced CRV stored images digitally processed. The correlation of the enhanced CRV image to the actual size of the phantom vessels was similar to the results obtained in the literature from digitally stored images. 5) 78 arterial measurements ranging 0.65 to 4.85 mm were evaluated both from the digital hard disc (D) and the CRV optical disc (CRV), using the same QCA analytical package. The correlation coefficient and the Standard Error of the Estimate between D and CRV values were respectively 0.997 and 0.076, no systematic over or underestimation occurred, and the mean variability was inferior to 0.1 mm. CONCLUSION: High-Resolution CRV-optical storage represents a cost-effective solution for excellent image quality equivalent to digitally stored images, permitting permanent electronic archiving inside the cath-lab, and allowing digital image processing and digital image communication.

Journal Article↗

Validation of coronary artery saphenous vein bypass graft diameter measurements using quantitative angiography.

The accepted value for reproducibility (true change) is two standard deviations (SD) of the differences between repeat measurements. It has been well established for coronary artery measurements using several different quantitative coronary angiography (QCA) systems, but it has not been well documented for saphenous vein grafts (SVG). The purpose of this study was to assess, using the Cardiovascular Measurement System (CMS), the measurement reproducibility of 24 vein grafts from 24 patients who had symptom-directed control angiography. Three equal graft segments were studied separately. Focal narrowings expressed in percent stenosis varied from 5 to 80% (mean 20.8 +/- 15.9%). The average minimum lumen diameter (MLD) was 3.07 +/- 0.81 mm and the average interpolated reference diameter (Ref. D) was 3.87 +/- 0.58 mm. We assessed the reproducibility of measurements obtained from two separate imagings of the graft in the same view but at least 20 minutes apart, near the beginning and at the end of the angiographic procedure (simulating baseline and end-trial examinations). The SD for differences in measurements (variability) was 0.183 mm for the MLD, 0.193 mm for the Ref.D, 0.184 mm for the mean diameter (Mean D) and 3.72% for the percent diameter stenosis (PDS). A reasonable true change cut-off for SVG measurements in our laboratory is > or = 0.4 mm for the minimum and mean lumen diameters, and > or = 10% for the PDS, when QCA is obtained with the QCA-CMS analytical software package.

Cineangiography↗

A new look at coronary angiograms: plaque morphology as a help to diagnosis and to evaluate outcome.

Characterization of plaque morphology can provide useful information beyond those generally yielded by the more traditional methods of interpretation of coronary angiograms based on assessment of severity of stenoses and number of diseased vessels. Focus on the culprit coronary lesion in acute myocardial infarction and in unstable angina allows recognition of the complex plaque and of presence of endoluminal thrombi that are closely associated to the mechanisms of the disease. Response to treatment in these clinical situations, and the healing process can be assessed by repeated opacifications of the lesion. The presence of a residual thrombus is associated with a worse clinical outcome and also a higher risk of complication if coronary angioplasty is performed. The prognostic information derived from the morphologic analysis extends to the chronic phase of the disease. The extent score of disease, defined as the sum of coronary artery segments showing a narrowing of any severity marks more severe disease and predicts future progression. Severity of stenosis is also a predictor. More severe lesions will occlude more frequently but most often without clinical consequences. Occlusion of less severe stenosis, on the other hand, leads to acute myocardial infarction or to the other manifestations of acute coronary syndromes. Other morphologic features are also associated with a higher risk of myocardial infarction. These include a geometry favoring blood flow separation and turbulence such as acute inflow and outflow angles of the stenosis and presence of a division within its vicinity. This new look at coronary angiograms may help orient therapy. Patients with angina and a significant stenosis will profit from a corrective intervention. Others with a high extent score should receive a comprehensive program for control of risk factors. Patients with a lesion of borderline significance at risk of activation should be closely monitored, and when clinical symptoms evolve, receive more intensive antithrombotic therapy. Quantification of the morphologic characteristics of the plaque, coupled to new techniques for endovascular imaging should lead in the future to better diagnostic and better risk stratification.

Angina, Unstable↗

Mediastinal and pericardial complications after heart transplantation. Not-so-unusual postoperative problems?

Of a total of 133 patients who underwent heart transplantation, 16(12%) had pericardial and mediastinal complications. Non-infectious pericardial complications, pericardial effusion and constriction were noted in ten patients, and infectious pericarditis or mediastinitis in six. Cardiac echocardiography, catheterization and magnetic resonance imaging were useful in assessing these problems. All patients underwent surgical treatment, pericardial drainage, pericardectomy or muscle flap closure. Twelve (75%) of these 16 patients are long-term survivors. In conclusion, pericardial and mediastinal complications are common after heart transplantation, and aggressive surgical treatment is most often effective in their control.

Adult↗

Definition and measurement of restenosis after successful coronary angioplasty: implications for clinical trials.

Angiographic restenosis represents the most established measure of long-term outcome in most prospective clinical trials of coronary angioplasty (PTCA). The accuracy of assessing this endpoint is of utmost importance. The purpose of this article is to propose guidelines for the use of coronary angiography in this setting. First, the cineangiograms must be of high technical quality and performed in a high proportion of consecutive patients in follow-up under controlled study conditions that are reproducible. Second, computer-assisted quantitative coronary angiographic analysis is essential to minimize interobserver and intraobserver variability in stenosis measurement between successive studies. The following recommendations are presented for quantitative coronary angiographic analysis. Because biplane orthogonal views cannot always be performed both at baseline and at follow-up, stenosis measurement in the single-plane, most severe view often constitutes the most consistent and practical approach. The edge-detection method is still much more reproducible and accurate than densitometry and should be the preferred method of analysis. Measurement of reference diameter by the interpolated method is more objective than measurement by the user-defined approach and should be used whenever possible. Finally, measurements of absolute minimum diameter and percent diameter stenosis are both important in the assessment of outcome in clinical trials. Absolute minimum diameters are independent of variations in reference diameter, and the extent of reduction in minimum diameter between the immediate postangioplasty and follow-up angiograms, when expressed in dichotomous or continuous fashion, accurately defines the extent of vessel wall hyperplasia as an endpoint. On the other hand, vessel size corresponds in general to the size of myocardium subserved, and absolute changes do not take into account this physiologic fact. Therefore defining restenosis in terms of significant reduction in percent diameter stenosis is also a useful approach because of its clinical relevance. Thus clinical restenosis requires that a successfully dilated segment (< 50% diameter stenosis) show a > or = 50% diameter stenosis at follow-up angiography with, in addition, a meaningful degree of change, that is, exceeding 2 SDs of observer variability in quantitative measurements which, in our experience, translates into > or = 15% difference between early postangioplasty and follow-up angiography measurements.

Angioplasty, Balloon, Coronary↗

Transluminal angioplasty of the subclavian artery in patients with internal mammary grafts.

From January 1987 to January 1992, 11 patients underwent percutaneous transluminal angioplasty (PTA) for the treatment of subclavian artery stenosis before or after coronary artery bypass grafting (CABG) using the internal mammary artery (IMA). There were 8 men and 3 women, with a mean age of 57 +/- 7 years. Four patients had PTA 1 to 4 months before undergoing CABG with IMA grafts, because of either asymptomatic supraclavicular murmurs or neurologic symptoms. Seven patients underwent PTA 2 to 37 months after CABG with IMA grafts, because of recurrent angina. Subclavian artery stenosis was on the left side in 9 patients, the right side in 1 patient, and bilateral in 1 patient. Ten PTA procedures were successful in 9 patients. All patients with post-CABG angina had reversal of the ischemia. There were three complications: one femoral artery thrombosis, one brachial plexus hematoma after an axillary approach, and one acute pulmonary edema after the procedure. Follow-up after PTA ranged from 1 to 60 months (mean, 38 +/- 17 months). Nine patients had no angina at follow-up and 2 had stable angina (class II) upon exertion. Upper-limb Doppler studies showed no evidence of restenosis in any of these patients at a mean follow-up of 38 months. Subclavian artery PTA is a useful alternative to IMA bypass grafting in patients with subclavian artery stenosis discovered preoperatively, and it is the treatment of choice for those presenting with post-CABG angina due to subclavian artery stenosis proximal to an IMA graft.

Adult↗

Clinical experience with the right gastroepiploic artery in coronary artery bypass grafting.

The excellent long-term results with the internal mammary artery for coronary artery bypass grafting have prompted the search for other conduits with similar characteristics. From December 1989 to December 1991, the right gastroepiploic artery (RGEA) has been used as an in situ graft to the posterior descending coronary artery in 51 patients at the Montreal Heart Institute. The patients' age averaged 50 +/- 11 years. Three-vessel coronary artery disease was present in 41 patients and two-vessel disease in the remaining 10 patients. In all but 1 patient, bilateral internal mammary artery grafting was performed in addition to RGEA grafting. The number of grafts per patient averaged 3.2 +/- 0.8. There was no operative mortality. Morbidity was minimal with only myocardial infarction and a pleural effusion in 1 patient. In 1 patient, a splenectomy had to be performed because of iatrogenic tear during dissection of the RGEA. The average hospital stay was 8.2 +/- 2.6 days. Enteral nutrition was resumed on average 2 days after operation. Angiographic evaluation of RGEA grafts was performed before discharge or within the first month after surgery in 31 patients. In 28 patients (28/31, 90%) the RGEA graft was patent, two grafts were occluded, and in the remaining patient, the graft could not be visualized due to technical difficulties during angiography. A second angiographic evaluation was performed in 5 patients, 1 year after operation. Four RGEAs were patent and 1 was occluded. Clinical follow-up averaged 4 months (range 1 to 15 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Results of percutaneous dilatation of subclavian artery stenosis in patients with internal mammary grafts].

From January 1987 to January 1992, 11 patients underwent percutaneous transluminal angioplasty (PTA) for subclavian artery (SCA) stenosis before or after coronary artery bypass grafting (CABG) with the internal mammary artery (IMA). There were 8 men and 3 women with a mean age of 57 +/- 7 years. Four patients had PTA 1 to 4 months before undergoing CABG with IMA grafts, because of asymptomatic subclavian murmurs or of neurologic symptoms. Seven patients underwent PTA 2 to 37 months after CABG with IMA grafts, because of recurrent angina. Subclavian artery stenosis was present on the left side in 9 patients, the right side in one patient, and was bilateral in one patient. Ten PTA procedures were successful in 9 patients. All patients with post-CABG angina had reversal of the ischemia. Three complications occurred: 1 femoral artery thrombosis, 1 branchial plexus hematoma after an axillary approach, and 1 acute pulmonary edema after the procedure. Follow-up ranged from 1 to 60 months after PTA (mean 38 +/- 17 months). Nine patients had no angina at follow-up and 2 presented with stable angina (class II) upon exertion. Upper-limb Doppler studies showed no evidence of restenosis in all of these patients, at a mean follow-up of 38 months. Subclavian artery percutaneous transluminal angioplasty is a useful alternative for candidates to IMA bypass grafting with SCA stenosis discovered pre-operatively, and it is the treatment of choice for those presenting with post-CABG angina due to SCA stenosis proximal to an IMA graft.

Angioplasty, Balloon↗

[Place of gastroepiploic and epigastric arteries in myocardial revascularization].

Seventy patients underwent coronary artery bypass grafting with the right gastroepiploic artery or the inferior epigastric artery between 1989 and 1992 at the Montreal Heart Institute. There were 68 men and 2 women with a mean age of 53 +/- 8 years, the right gastroepiploic artery in situ was anastomosed to the right coronary artery in 55 patients and the inferior epigastric artery (free graft) was used in 18 patients. Double internal thoracic artery grafts were used in all patients. Early patency rate of right gastroepiploic artery and inferior epigastric artery grafts was 91% (31/34 grafts) and 57% (8/14 grafts) respectively. One patient died after surgery (1.4%) from acute renal failure and one patient developed an acute myocardial infarction (1.4%) at surgery. Fifty-five patients (55/57, 96%) showed no evidence of angina at the last follow-up. In conclusion, patency rate and clinical results of coronary artery bypass grafting with the right gastroepiploic artery graft were excellent and patency rate of inferior epigastric artery graft was unsatisfactory. We suggest that epigastric artery grafts should be used with caution, only when no other alternative is available.

Abdomen↗

[Magnetic resonance imaging in the diagnosis and follow-up of false aneurysms after Bentall's operation].

The prevalence and natural history of pseudo-aneurysm (PA) following Bentall procedure has not been established. To determine the follow-up of such patients, we report our experience with magnetic resonance imaging (MRI) used since 1988. At first, spin-echo exam, PA was suspected in 19 patients among 27 patients who underwent aortic valve and ascending aortic replacement between 1980 and 1991. Mean PA diameter was < 4 cm in 13 patients (group 1) and > or = 4 cm in six patients (group 2). Two patients of group 1 were lost at follow-up while two others died after the first spin-echo exam, one death being related to PA formation. Repeated MRIs were done in nine patients of group 1 and all patients of group 2 averaging respectively 2.2 +/- 1.1 exams per patient for group 1 and 1.8 +/- 1.1 for group 2. PA regressed in six patients of group 1 and one patient of group 2 thus suggesting thrombosed PA or postoperative haematoma. PA remained stable in two patients of group 1 and one patient of group 2. One patient of group 1 in whom PA increased at follow-up died suddenly. Four patients of group 2 required surgical correction of their PA. One of these patients died of massive hemoptysis 2 months following reintervention. Recently, addition of cine MRI allows visualization of turbulent flow within the PA thus increasing MRI specificity for PA diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Pseudoaneurysm after Bentall repair: magnetic resonance imaging assessment.

The prevalence and natural history of pseudoaneurysms (PA) following Bentall procedure has not been established. To determine the follow-up of PA in patients, the authors report their experience with magnetic resonance imaging (MRI) since 1988. Spin-echo technique suspected PA in 19 of the 27 patients who underwent aortic valve and ascending aortic replacement between 1980 and 1991. Mean PA diameter was less than 4 cm in 13 patients (group 1) and at least 4 cm in six patients (group 2). Two patients in group 1 were lost at follow-up while two others in this group died after first spin-echo examination (one death was related to PA formation). Repeated MRIs were thus possible in nine patients in group 1 and in all patients in group 2, averaging 2.2 +/- 1.1 examinations per patient for group 1 and 1.8 +/- 1.1 for group 2. PA assessed in six group 1 patients and one group 2 patient suggested thrombosed PA or postoperative hematoma. PA remained stable in two group 1 patients and one group 2 patient. One patient from group 1, in whom PA increased at follow-up, died suddenly. Four patients in group 2 required correction of PA, which had increased in diameter. Recently, addition of cine MRI has allowed visualization of turbulent flow within PA, thus increasing MRI specificity for PA diagnosis. In conclusion, MRI constitutes a reliable noninvasive imaging technique for diagnosis and follow-up of PA after Bentall repair.

Aortic Dissection↗