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Clinical 3D and 4D Imaging of the Thoracic Aorta

  • D. Fleischmann
  • D. C. Miller

Abstract

Modern day CT angiography (CTA) has replaced diagnostic angiography for the evaluation of thoracic aortic diseases. The development of CTA with retrospective ECG gating has been driven by coronary artery CTA, but it also provides significant benefits to imaging of the thoracic aorta. Retrospective ECG gating virtually eliminates cardiac pulsation artifacts and has therefore extended the clinical applicability of CTA to finally also include the aortic root. Moreover, ECG gating allows cardiac phase-resolved (‘timeresolved’) cine imaging and visualization, adding a ‘fourth dimension’ (4D) to this technique.

Keywords

Compute Tomography Angiography Aortic Dissection Thoracic Aorta Aortic Root Coronary Compute Tomography Angiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Svensson LG, Labib SB, Eisenhauer AC, Butterly JR (1999) Intimal tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation 99:1331–1336PubMedGoogle Scholar
  2. 2.
    Fleischmann D, Rubin GD, Bankier AA, Hittmair K (2000) Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology 214:363–371PubMedGoogle Scholar
  3. 3.
    Roman MJ, Devereux RB, Kramer-Fox R, O’Loughlin J (1989) Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 64:507–512PubMedCrossRefGoogle Scholar
  4. 4.
    Davies RR, Gallo A, Coady MA et al (2006) Novel measurement of relative aortic size predicts rupture of thoracic aortic aneurysms. Ann Thorac Surg 81:169–177PubMedCrossRefGoogle Scholar
  5. 5.
    Kim SY, Martin N, Hsia EC et al (2005) Management of aortic disease in Marfan syndrome: a decision analysis. Arch Intern Med 165:749–755PubMedCrossRefGoogle Scholar
  6. 6.
    Bonow RO, Carabello BA, Kanu C et al (2006) ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 114:e84–e231PubMedCrossRefGoogle Scholar
  7. 7.
    Ring WS (2000) Congenital Heart Surgery Nomenclature and Database Project: aortic aneurysm, sinus of valsalva aneurysm, 130 and aortic dissection. The Annals of Thoracic Surgery 69:147–163CrossRefGoogle Scholar
  8. 8.
    Judge DP, Dietz HC (2005) Marfan’s syndrome. Lancet 366:1965–1976PubMedCrossRefGoogle Scholar
  9. 9.
    Fedak PW, Verma S, David TE et al (2002) Clinical and patho-physiological implications of a bicuspid aortic valve. Circulation 106:900–904PubMedCrossRefGoogle Scholar
  10. 10.
    Gardner TJ, Spray TL, Rob C (2004) Operative cardiac surgery. Arnold (distributed in the USA by Oxford University Press) London, New YorkGoogle Scholar
  11. 11.
    Bentall H, De Bono A (1968) A technique for complete replacement of the ascending aorta. Thorax 23:338–339PubMedCrossRefGoogle Scholar
  12. 12.
    Miller DC (2003) Valve-sparing aortic root replacement in patients with the Marfan syndrome. J Thorac Cardiovasc Surg 125:773–778PubMedCrossRefGoogle Scholar
  13. 13.
    Sarsam MA, Yacoub M (1993) Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg 105:435–438PubMedGoogle Scholar
  14. 14.
    David TE, Feindel CM (1992) An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 103:617–621PubMedGoogle Scholar
  15. 15.
    Hayter RG, Rhea JT, Small A et al (2006) Suspected aortic dissection and other aortic disorders: multi-detector row CT in 373 cases in the emergency setting. Radiology 238:841–852PubMedCrossRefGoogle Scholar
  16. 16.
    Dake MD, Kato N, Mitchell RS et al (1999) Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 340:1546–1552PubMedCrossRefGoogle Scholar
  17. 17.
    Dake MD, Wang DS (2006) Will stent-graft repair emerge as treatment of choice for acute type B dissection? Semin Vasc Surg 19:40–47PubMedCrossRefGoogle Scholar
  18. 18.
    Evangelista A, Mukherjee D, Mehta RH et al (2005) Acute intramural hematoma of the aorta: a mystery in evolution. Circulation 111:1063–1070PubMedCrossRefGoogle Scholar
  19. 19.
    Daily PO, Trueblood HW, Stinson EB et al (1970) Management of acute aortic dissections. Ann Thorac Surg 10:237–247PubMedCrossRefGoogle Scholar
  20. 20.
    Ergin MA, O’Connor J, Guinto R, Griepp RB (1982) Experience with profound hypothermia and circulatory arrest in the treatment of aneurysms of the aortic arch. Aortic arch replacement for acute arch dissections. Journal of thoracic and cardiovascular surgery 84:649–655PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • D. Fleischmann
    • 1
  • D. C. Miller
    • 2
  1. 1.Department of RadiologyStanford University Medical CenterStanford
  2. 2.Department of Cardiothoracic SurgeryStanford University Medical CenterStanfordUSA

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