title: Endovascular repair of a thoracic aortic aneurysm in pregnancy at 22 weeks of gestation.
abstract: Thoracic aortic aneurysm is a rare condition that carries a critical risk of rupture and mortality. These risks are increased during pregnancy because of a progressively hyperdynamic pattern of circulation. Simultaneously, pregnancy-imposed limitations on the use of ionized radiation and intravenous contrast agents may render conventional techniques for imaging and repair confirmation less acceptable. We describe a novel approach to intraoperative management of an endovascular repair for symptomatic thoracic saccular aneurysm in a pregnant patient, based on intravascular ultrasound and transesophageal echocardiography, with maintenance of uterine perfusion. The patient recovered well and proceeded to a normal delivery. Despite a favorable outcome in this case, further studies of perioperative management of aortic disease in pregnancy are needed.
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla.
authors.forename: Veer
authors.initials: V
authors.lastname: Chahwala
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla.
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla.
authors.forename: Atif
authors.initials: A
authors.lastname: Baqai
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla.
authors.forename: Edward
authors.initials: E
authors.lastname: Gologorsky
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla. Electronic address: jrey@med.miami.edu.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rey
authors.affiliation: Division of Vascular and Endovascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Fla.
authors.forename: Handel R
authors.initials: HR
authors.lastname: Robinson
mesh_terms: D000328:Adult; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D003287:Contrast Media / Q000009:adverse effects; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D018810:Magnetic Resonance Angiography; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal
chemical_list: D003287:Contrast Media