Abstract 17101: Identification of Aortic Tissue at Risk for Dysfunction in Patients With Aortopathy Using 4D Flow MRI: Impact of Surgical Intervention
Introduction: Prophylactic resection for patients with aortopathy is based on diameter thresholds. However, rupture and acute dissection can occur below these thresholds and might be related to valve-mediated hemodynamics. We previously showed association between aortic medial wall dysregulation and high wall shear stress (WSS) using 4D flow MRI. Our aim is to study the effect of aortic interventions on these “at-risk” areas.
Methods: Fifty-four aortopathy patients underwent 2 MRIs: 34 had surgical valve or aorta repair/replacement between imaging sessions; 20 ‘control’ patients did not have surgery. For each 4D flow MRI dataset, the area representing systolic WSS above the 95% confidence interval was computed using an atlas of physiologically normal values, while excluding resected area in surgery patients.
Results: The table summarizes patient demographics and at-risk aortic tissue area. While overall low and stable at-risk areas were obtained in controls despite the significantly longer follow-up duration, high differences were observed after intervention in the surgery group (Figure), showing a systematic decrease after aortic valve replacement alone with a biovalve.
Conclusions: This preliminary work demonstrates the feasibility of 4D flow MRI to provide insight into the effect of surgery on aortic at-risk tissue and suggests highly variable response among patients, which is being further studied with ongoing recruitment.
Author Disclosures: E. Bollache: None. P.W. Fedak: None. P. van Ooij: None. O. Rahman: None. A. Hong: None. E.J. Keller: None. S. Malaisrie: None. P.M. McCarthy: None. J. Carr: None. J. Collins: None. M. Markl: None. A.J. Barker: None.
- © 2016 by American Heart Association, Inc.