Learning objectives
To illustrate the most common features and pitfalls in CT imaging following cardiac surgery procedure.
To learn how to recognize and distinguish the most frequent complications ofspecific procedures.
Background
In the radiological clinical routine, it is increasingly common to find patients who perform serial checks in order to detect any post-surgical complications, in which radiological imaging has taken an essential role [5].
Findings and procedure details
On suspicion of active bleeding, it is necessary to perform a multi-phase acquisition protocol with:
-Non-contrast scan
-Arterial phase (30-35 '' from the CA injection) to detect the vessel/s that is/are supplying the bleeding
-Venous phase
-Late phase (4-5 'from the injection)
A rapid injection of contrast agent (5 mL/sec) is necessary to achieve an optimal arterial enhancement (250 to 300 HU). This enhancement makes possible the discrimination of intravascular contrast from aortic calcification and thrombus.
Normal appearance of post-surgical changes
Duringthe days following cardiac...
Conclusion
A complete knowledge of the large spectrum of the normal findings and complication-related features can help the general radiologist to easily achieve a prompt diagnosis and to address the appropriate treatment in patients with history of cardiac surgery.
Personal information and conflict of interest
N. Galea; Rome/IT - nothing to disclose F. Catapano; Rome, ROMA (RM)/IT - nothing to disclose G. Cundari; Rome/IT - nothing to disclose M. Francone; Rome/IT - nothing to disclose C. Catalano; Rome/IT - nothing to disclose G. Pambianchi; Fermo, FM/IT - nothing to disclose L. Marchitelli; Rome/IT - nothing to disclose I. Carbone; Rome/IT - nothing to disclose
References
5. Bhatnagar G, Vardhanabhuti V, Nensey RR, Sidhu HS, Morgan-Hughes G, Roobottom CA (2013) The role of multidetector computed tomography coronary angiography in imaging complications post-cardiac surgery. Clin Radiol 68:e254-265.
6. Tolsma M, Kroner A, van den Hombergh CL et al (2011) The clinical value of routine chest radiographs in the first 24 hours after cardiac surgery. Anesth Analg 112:139-142.
7. Sepehripour AH, Farid S, Shah R (2012) Is routine chest radiography indicated following chest drain removal after cardiothoracic surgery? Interact Cardiovasc Thorac Surg 14:834-838....
