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(Circulation. 2002;105:2929.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Aortic Allograft in the Pulmonary Position After Twenty-Three Years

Pascal M. Dohmen, MD; Jianshi Liu, MD; Alexander Lembcke, MD; Wolfgang Konertz, MD, PhD

From the Departments of Cardiovascular Surgery (P.M.D., J.L., W.K.) and Radiology (A.L.), Charité, Humboldt University Berlin, Berlin, Germany.

Correspondence to P.M. Dohmen, MD, Dept of Cardiovascular Surgery, Charité, Humboldt University Berlin, Schumannstraße 20/21, D-10117 Berlin, Germany. E-mail pascal.dohmen@charite.de

Multislice computed tomography images of a patient with extreme aortic allograft degeneration and Dacron graft calcification after right ventricular outflow tract reconstruction 23 years previously (Figure 1). The extra-anatomic horseshoe graft was taken down, and anatomic pulmonary allograft implantation was performed. To reach the right pulmonary artery, extension with a 14-mm Dacron tube was necessary (Figure 2).

View larger version (85K): [in this window] [in a new window]   Figure 1. Three-dimensional reconstruction of the right ventricular outflow tract before the operation shows the anterior position of the horseshoe graft connecting both pulmonary arteries. Compression of the graft close to the homograft anastomosis is visible.

View larger version (102K): [in this window] [in a new window]   Figure 2. Anatomic position of the pulmonary allograft.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.