[Radiologic follow-up of the replacement of the ascending aorta with a composite graft. Comparison of angiography and computed tomography].

Only a few long-term results after replacement of the ascending aorta with a composite graft are available. Twelve patients were therefore evaluated clinically, by computer tomography (CT) and angiography 8-102 months postoperatively. 7 patients had a type I dissecting aneurysm, 1 patient a type II and 4 patients a true aneurysm. Clinically there were no signs of valvular dysfunction or symptoms of lower limb ischemia. All patients were in functional class I or II. On CT all patients with a type I aneurysm showed a chronic dissection with a perfused false lumen extending into the descending aorta. Opacification of the coronary ostia was possible in 4 patients. In 1 patient a false aneurysm at the distal suture line was visualized. Angiography confirmed all CT findings. Coronary angiography demonstrated widely patent coronary ostia. No false aneurysm around the implants was found. Thus, functional results after composite graft operation are good despite the persistence of massive chronic dissection in all patients with a type I aneurysm. CT is an ideal method of evaluating the extent of this dissection. Angiography is necessary to visualize the anatomy of the aortic root and of the coronary ostia.