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[Clinical significance of transesophageal echocardiography for evaluation of patients after Bentall's operation: detection of graft failure].

Leakage from the composite graft at the site of coronary anastomosis into the perigraftal space (pseudoaneurysm) is an important complication of Bentall's operation. The clinical value of transesophageal echocardiography (TEE) for detecting this graft failure was evaluated in 30 patients who underwent Bentall's operation or Piehler's modification. Three patients (10%) had perigraftal leakage (pseudoaneurysm). TEE demonstrated the leakage site which was not clearly showed by computed tomography (CT) scan and aortography. The detection rate of the anastomosed native coronary artery was 89% (left: 100%, right: 67%). Interposition graft by Pichler's modification method was detected in 96% (left: 100%, right: 92%) of cases by TEE, but only in 43% (left: 57%, right: 29%) by CT scan (left: p < 0.005, right: p < 0.0001). The detection rate of the right coronary artery, interposition graft to right coronary artery, and their color signals were lower than those of the left coronary artery. TEE has considerable diagnostic value in evaluating patients after Bentall's operation.