CT findings following the cabrol composite graft procedure

Postoperative imaging of thoracic aortic repairs

Imaging plays a crucial role in the postoperative monitoring of thoracic aortic repairs. With the development of multiple surgical techniques to repair the ascending aorta and aortic arch, it can be a daunting challenge for the radiologist to diagnose potential pathologies in this sea of various techniques, each with their own normal postoperative appearance and potential complications. In this paper, we will provide a comprehensive review of the postoperative imaging in the setting of thoracic aortic repairs, including the role of imaging, components of thoracic aortic repairs, the normal postoperative appearance, and potential complications.

Heart failure and severe pulmonary hypertension caused by distal detachment of the valve conduit 16 years after the Cabrol composite graft procedure

We report the case of a patient who underwent Cabrol composite graft procedure for ascending aorta aneurysm and aortic regurgitation. Sixteen years later he developed progressive dyspnea and a left-to-right shunt caused by distal detachment of the valve conduit with persistence of the perigraft space-right atrial fistula visualized with echocardiography. Our case shows that late manifestations of surgical complications of the Cabrol procedure may occur and transesophageal echocardiography may allow a comprehensive assessment in these patients. However, because surgical management of ascending aorta aneurysms has changed in the last decades a detailed knowledge of the surgical technique used is mandatory for adequate interpretation of transesophageal echocardiographic results.

Percutaneous intervention through a Cabrol composite graft

Similar to other surgical techniques, ascending thoracic aortic repair has evolved through a series of modifications, each with improvement in longevity, morbidity, and mortality. Until recently, most, if not all, aortic composite graft-coronary ostial anastamotic complications have been addressed with repeat surgery. Due to this, most interventional cardiologists have little to no experience in approaching postsurgical aortic composite graft-coronary ostial anastamotic lesions percutaneously when the anatomy is altered by a Cabrol interposition graft. Nevertheless, it is important that operators are aware of the various surgical techniques used to repair the ascending aorta and reimplant the coronary arteries. Furthermore, in the present era of addressing more and more stenotic lesions percutaneously, it is important to have knowledge into which type of lesion lends itself to a percutaneous approach. Our review of the literature reveals that there have been no reported cases of percutaneous interventions of the native coronary arteries through a Cabrol composite graft. We report the first case of percutaneous intervention of an unprotected left main anastamotic stenosis through a Cabrol composite graft.