XML Template (2014) [16.9.2014–7:45pm] //blrnas3.glyph.com/cenpro/ApplicationFiles/Journals/SAGE/3B2/AANJ/Vol00000/140210/APPFile/SG-AANJ140210.3d
(AAN)
[1–1] [PREPRINTER stage]
Images in Cardiothoracic Medicine and Surgery
Successful surgical treatment of ruptured thoracic aortic aneurysm in pregnancy
Asian Cardiovascular & Thoracic Annals 0(0) 1 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492314553443 aan.sagepub.com
Soki Kurumisawa and Yoshio Misawa
Figure 2. Postoperative computed tomography findings. (a) The proximal anastomosis site was at the ascending aorta. (b) The distal anastomosis was at the descending aorta and the aortic coarctation was closed (white arrow). Figure 1. Preoperative computed tomography findings. (a) A thoracic aneurysm (black arrow) and a fetus in the pelvis were recognized. The distal aortic arch was narrowed (white arrow) compared to the ascending aorta. (b) A thoracic aneurysm with extravasation was demonstrated.
A 31-year-old woman who was 38-weeks pregnant was referred for surgery of a ruptured thoracic aortic aneurysm associated with aortic coarctation. Computed tomography showed a large thoracic aneurysm with pleural effusion as well as a fetus (Figure 1). Her family history was negative for cardiovascular diseases or sudden death. Under general anesthesia, she successfully underwent an emergency cesarean section by an obstetric team, and then aortic surgery was performed by our cardiovascular team. Cardiopulmonary bypass was established via a median sternotomy and an additional left anterior thoracotomy. The ascending aorta and right femoral artery were cannulated for cardiopulmonary bypass. A 1000-mL hemothorax was drained from
the left pleural cavity. Coarctation of the aorta was observed proximal to the aneurysm. After deep hypothermic circulatory arrest, the aneurysm was replaced with a 22-mm Dacron graft. We chose a proximal anastomosis site on the ascending aorta, and the aortic coarctation was closed (Figure 2). The cardiopulmonary bypass time was 301 min, cardiac ischemic time was 30 min, and hypothermic arrest time was 30 min. The postoperative course was uneventful for both the mother and the neonate. Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
Department of Cardiovascular Surgery, Jichi Medical University, Shimotsuke, Japan Corresponding author: Yoshio Misawa, Department of Cardiovascular Surgery, Jichi Medical University Yakushiji, Shimotsuke-shi, Tochigi-ken, Japan. Email: [email protected]
Downloaded from aan.sagepub.com by guest on November 14, 2015
(AAN)
[1–1] [PREPRINTER stage]
Images in Cardiothoracic Medicine and Surgery
Successful surgical treatment of ruptured thoracic aortic aneurysm in pregnancy
Asian Cardiovascular & Thoracic Annals 0(0) 1 ß The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492314553443 aan.sagepub.com
Soki Kurumisawa and Yoshio Misawa
Figure 2. Postoperative computed tomography findings. (a) The proximal anastomosis site was at the ascending aorta. (b) The distal anastomosis was at the descending aorta and the aortic coarctation was closed (white arrow). Figure 1. Preoperative computed tomography findings. (a) A thoracic aneurysm (black arrow) and a fetus in the pelvis were recognized. The distal aortic arch was narrowed (white arrow) compared to the ascending aorta. (b) A thoracic aneurysm with extravasation was demonstrated.
A 31-year-old woman who was 38-weeks pregnant was referred for surgery of a ruptured thoracic aortic aneurysm associated with aortic coarctation. Computed tomography showed a large thoracic aneurysm with pleural effusion as well as a fetus (Figure 1). Her family history was negative for cardiovascular diseases or sudden death. Under general anesthesia, she successfully underwent an emergency cesarean section by an obstetric team, and then aortic surgery was performed by our cardiovascular team. Cardiopulmonary bypass was established via a median sternotomy and an additional left anterior thoracotomy. The ascending aorta and right femoral artery were cannulated for cardiopulmonary bypass. A 1000-mL hemothorax was drained from
the left pleural cavity. Coarctation of the aorta was observed proximal to the aneurysm. After deep hypothermic circulatory arrest, the aneurysm was replaced with a 22-mm Dacron graft. We chose a proximal anastomosis site on the ascending aorta, and the aortic coarctation was closed (Figure 2). The cardiopulmonary bypass time was 301 min, cardiac ischemic time was 30 min, and hypothermic arrest time was 30 min. The postoperative course was uneventful for both the mother and the neonate. Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
Department of Cardiovascular Surgery, Jichi Medical University, Shimotsuke, Japan Corresponding author: Yoshio Misawa, Department of Cardiovascular Surgery, Jichi Medical University Yakushiji, Shimotsuke-shi, Tochigi-ken, Japan. Email: [email protected]
Downloaded from aan.sagepub.com by guest on November 14, 2015
