To answer you as plainly as possible: YES, in most cases, annual imaging—usually a CT angiogram or MRI—is considered necessary after aortic graft surgery, especially in the first few years post-op. The goal is to monitor for complications such as aneurysm formation downstream from the graft, progression of a dissection flap if you had one, or changes in the native aorta that might require further intervention. Over time, and depending on how stable things look, your care team may stretch out the intervals. But surveillance is for life. I get mine annual and every three years with contrast dye. The contrast helps visualize things but its hard on your kidneys. The where it was explained to me is that your kidneys are a little bit like a donor cartridge. They don't last forever and every time you inject contrast, it reduces their functionality. All of that contrast overtime can add up and cause more problems than it solves. My thoracic surgeon was very adamant with me about getting annual CT scans.

It's not about paranoia—it's about prevention. These scans catch changes before they become emergencies. I get mine regularly, and while I don’t love the radiation, I love knowing that I’m still ahead of the curve. It gives me peace of mind and lets me focus on living. I had emergency open-heart surgery almost 10 years ago for a Type A aortic dissection. They put in a Dacron graft to replace the ascending aorta and part of the arch. Since then, I've lived with that graft in my chest, and like you, I’ve asked a lot of the same questions. Peace.