[Operation of acute dissecting aortic aneurysm in the 25th week of pregnancy using hypothermic extracorporeal circulation].
We report on a 24 + 2 weeks pregnant woman with Marfan's syndrome, who acutely developed a dissecting aortic aneurysm with aortic valve insufficiency. Emergency surgery was performed by using hypothermic extracorporeal circulation, whilst the aortic valve and ascending aorta were replaced by a synthetic graft. Foetal heart rates, continuously monitored by using Doppler ultrasound, were shown to be closely correlated with perfusion pressures. By applying perfusion pressures of 90-100 mmHg, we were able to maintain foetal heart rates of approximately 100/min. During the first postoperative day, the CTG was normal for gestational age and no contractions were noted. During the second postoperative night, the patient prematurely delivered a dead 820 g infant (Apgar score 0/0/0/0). In view of this case report, opportunities and problems associated with an application of extracorporeal circulation during pregnancy are discussed.
Thaler
C J
CJ
Frauenklinik Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Korell
M
M
Klinner
U
U
Reichart
B
B
Hepp
H
H
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005112:Extracorporeal Circulation; D005260:Female; D005313:Fetal Death; D005323:Fetal Monitoring / Q000295:instrumentation; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D008382:Marfan Syndrome / Q000601:surgery*; D016343:Monitoring, Intraoperative / Q000295:instrumentation; D011183:Postoperative Complications / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation