Document Detail


Long-term follow-up, computed tomography, and computational fluid dynamics of the Cabrol procedure.
MedLine Citation:
PMID:  19913239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The Cabrol procedure is characterized by insertion of an ascending aortic composite graft with reimplantation of the coronary arteries by the interposition of a graft tube. Our purpose is to report the clinical long-term follow-up and computed tomographic findings in patients having undergone the Cabrol procedure and to determine blood flow in the Cabrol graft using computational fluid dynamics. METHODS: Clinical follow-up (76.6 +/- 16.6 months) and dual-source computed tomographic angiography data of 7 patients (all men, mean age 54.9 +/- 9.6 years) with 12 Cabrol grafts (left main coronary artery, n = 7; right coronary artery, n = 5) were reviewed. In 2 patients, the right coronary artery was directly reattached to the aortic graft. Computational fluid dynamics were calculated using computed tomographic data of a patient with the Cabrol procedure and compared with those in a Valsalva graft and a healthy aortic root. RESULTS: Computed tomography showed Cabrol graft occlusions to 1 of 7 (14%) left main and of 2 of 5 (40%) right coronary arteries. Six grafts to the left main and 3 to the right coronary artery were fully patent, similar to the 2 directly reattached right coronary arteries to the aortic graft. Computational fluid dynamics results show similar blood flow parameters into the coronaries for the healthy aortic root and Valsalva graft. In the Cabrol graft, a spiraling flow pattern with low flow into the right coronary artery was found (right coronary artery = 1 mL/min at both systole and diastole). CONCLUSIONS: Our study indicates low flow rates particularly in the right Cabrol graft correlating with a higher incidence of occlusions of the right as compared with the left Cabrol graft at long-term follow-up.
Authors:
Joseph Knight; Stephan Baum?ller; Vartan Kurtcuoglu; Marko Turina; Juraj Turina; Ulrich Schurr; Dimos Poulikakos; William Marshall; Hatem Alkadhi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-12
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  139     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1602-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aorta / surgery*
Aortic Valve / surgery*
Aortography / methods
Blood Vessel Prosthesis*
Cardiac Surgical Procedures / methods
Coronary Vessels / surgery*
Follow-Up Studies
Humans
Male
Middle Aged
Regional Blood Flow
Retrospective Studies
Time Factors
Tomography, X-Ray Computed*
Vascular Surgical Procedures / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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