Transluminal endovascular aortic repair and pregnancy: a case report

Duiella Sf ,Ossola Mw ,C Bonanomi ,Giorgia Gaia ,Giulia Rossi

doi:10.15761/jic.1000112

Abstract

Acute Traumatic Aortic Transection (ATAT) is a dramatic event related to extremely high mortality. Transluminal Endovascular Aortic Repair (TEVAR) is currently the preferred Strategy for such lesions and offers an alternative to open surgical repair. In this article we discuss the case of a 21-year old woman who suffered from an ATAT of the aortic isthmus along with multiple fractures and visceral lesions during a car accident. Three years after the endovascular repair of the aorta our patient became pregnant. The pregnancy evolved without any complications, but since no spontaneous labour occurred, and the patient refused labour induction, we decided to perform an elective caesarean section at 41 week. To our knowledge, this is the first case described in literature of a patient undergoing a caesarean section after TEVAR for ATAT.

Highlights

Acute traumatic transection of the aorta is a high mortality related event, burdened by the multiple traumatism frequently associated
In order to decrease the extremely high mortality rate associated to this traumatic event is necessary an immediate diagnosis and endovascular treatment
Regarding the treatment approach Transluminal Endovascular Aortic Repair (TEVAR) has become the preferred strategy for such lesions and offers an alternative to open surgical repair, which seems to be associated to a higher mortality rate and procedure related complications

Summary

Introduction

Acute traumatic transection of the aorta is a high mortality related event, burdened by the multiple traumatism frequently associated (such as abdominal and pelvic lesions or head trauma). In order to decrease the extremely high mortality rate associated to this traumatic event is necessary an immediate diagnosis and endovascular treatment (within 24 hours). Regarding the treatment approach Transluminal Endovascular Aortic Repair (TEVAR) has become the preferred strategy for such lesions and offers an alternative to open surgical repair, which seems to be associated to a higher mortality rate and procedure related complications. Due to the high mortality and frequent complications related to this event, pregnancy is rare in these patients; currently, according to the scientific literature, only one case of uncomplicated vaginal delivery was described. We describe the second case of a patient with an uncomplicated pregnancy ended with a caesarean section

Case report

CT scan was performed one month before the patient became

Findings

Discussion