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Apicoaortic Conduits: Indications, Complications, and Imaging Techniques

Nance, John W. Jr MD*; Barraza, J. Michael BS*; Henzler, Thomas MD; McMaster, William G. MD*; Kratz, John M. MD; Schoepf, U. Joseph MD, FAHA, FSCBT-MR, FSCCT*,§

doi: 10.1097/RTI.0b013e31820e4701
Review Article

Left ventricular apex to descending aorta conduits may be used as a last resort treatment of severe left ventricular outflow tract obstruction in cases in which alternative therapies are contraindicated. Although this technique is rarely used in current practice for congenital cases, its use in the elderly population is increasing, largely due to the expansion of this patient cohort and associated comorbidities precluding aortic valve replacement, the most common of which are a severely calcified “porcelain” aorta and/or previous coronary artery bypass grafts preventing aortic root manipulation. Diagnostic imaging is essential in the presurgical workup and subsequent follow-up of these patients, as complications of the procedure are potentially life threatening and are not rare. Several imaging modalities may be used, each with advantages and disadvantages. Both anatomic and functional assessments play a role in the comprehensive evaluation of both presurgical and postsurgical patients.

Departments of *Radiology and Radiological Science

Surgery

§Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC

Department of Clinical Radiology and Nuclear Medicine, University Medical Center, Mannheim, Medical Faculty Mannheim—Heidelberg University, Mannheim, Germany

U. Joseph Schoepf is a consultant for and receives research support from Bayer-Schering, Bracco, General Electric, Medrad, and Siemens. The other authors have no conflict of interest to disclose.

Reprints: U. Joseph Schoepf, MD, FAHA, FSCBT-MR, FSCCT, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, MSC 226, Charleston, SC 29401 (e-mail: schoepf@musc.edu).

© 2012 Lippincott Williams & Wilkins, Inc.