A metallic valve prosthesis is seen at the region of the aortic valve. The ascending aorta is replaced by a prosthetic graft with dense felt rings marking and reinforcing the sites of anastomosis. These findings are consistent with changes after Bentall procedure.
There is accumulation of opacified blood in the perigraft space presumed from intractable leak at the region of the aortic root (perigraft leak). The engorged perigraft space compresses the superior vena cava, main and right pulmonary arteries.
A patent Cabrol fistula is seen as a tubular communication between the perigraft space and the right atrium.
Intimal flap from prior dissection is evident in the arch and descending segment of the aorta.
There is cardiomegaly, reflux of contrast into the inferior vena cava and bilateral pleural effusion.
Post-sternotomy changes are also noted.