Christian Oliver Ritter MD, Presenter: Nothing to Disclose

Ursula Baier MD, Abstract Co-Author: Nothing to Disclose

Sebastian-Patrick Sommer MD, Abstract Co-Author: Nothing to Disclose

Armin Gorski MD, Abstract Co-Author: Nothing to Disclose

Dietbert Hahn MD, Abstract Co-Author: Nothing to Disclose

Meinrad Johannes Beer MD, Abstract Co-Author: Research Consultant, Shire plc

Comparative functional MRI to analyse the postoperative result after ROSS-procedure in patients with high-grade aortic valve stenosis (AVS) operated with the free aortic root replacement (ARR) or the subcoronary (SC) technique.

We analysed 56 cardiac MRI examinations of 14 patients with high-grade aortic valve stenosis. In seven patients (44±10 years) the aortic valve (AV) has been replaced with an autograft in ARR-technique and in another seven patients (49±8 years) in SC-technique. We acquired the following sequences with a 1.5 Tesla scanner: T2w-HASTE, SSFP-cinematography, phase-contrast flow-measurements [AV and pulmonary valve (PV)] and phase-sensitive inversion-recovery. All patients were examined postoperative after 7-10 days (E1) as well after 3(E2), 6(E3) and 12(E4) month.

Left ventricular mass showed an expected regression (LVMR): ARR E1: 200±71g, E4: 180±61g; SC E1: 202±74g, E4: 131±34g. The ejection fraction (EF) normalized over time in both groups. The AV orifice area did not increase significantly in both groups: ARR E1: 4.7±1.7cm², E4: 5.4±1.2cm²; SC E1: 3.2±0.2cm², E4: 3.9±1,4cm². An AV-regurgitation (AVR) was depicted in the ARR-group in E1 in four patients (3.9±2.3cc) and in E4 in seven patients (5.9±2.5cc; p=0.03). In the SC-group two patients (E1) and five patients (E4) showed an AVR of 2.2±0.5cc respectively 7.1±5.2cc (p=0.02). In the ARR-group 83% in the E1 and 100% in the E4 showed a non significant PV-regurgitation (PVR), in the SC-group 83% in E1 and 86% in E4.

The postoperative one-year follow-up in patients with AV-replacement in autograft-technique does not show a significant difference of the functional outcome in terms of the different operation techniques (ARR and SC) in our preliminary small patient collective. In both groups EF normalizes, a LVMR and the development of a minor AVR and PVR can be detected.

Magnetic resonance imaging is a valuable and accurate noninvasive tool for the postoperative assessment of autograft function as well as ventricular functional parameters.

Ritter, C, Baier, U, Sommer, S, Gorski, A, Hahn, D, Beer, M, Comparative Functional MRI in Patients after ROSS Procedure with Aortic Root Replacement or Subcoronary Implantation Technique: A Preliminary First Year Postoperative Follow-up.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016793.html