CARDIOVASCULAR DISEASE is a leading cause of mortality during pregnancy in the United
States.
1
One cardiovascular condition, an aortic pseudoaneurysm, has high risk for fatal rupture,
especially when exacerbated by physiologic changes that occur during pregnancy, including
hormonal fluctuations that weaken the aortic wall and reduce its ability to withstand
pregnancy-induced increases in blood volume, heart rate, and cardiac output.
2
Emergent surgical repair of this serious condition is needed to preserve life. Emergent
surgical repair, however, is complicated in patients with multiple previous cardiac
surgeries, as sternal re-entry may breach the ascending aortic pseudoaneurysm and
cause exsanguination. Aortic clamping and myocardial protection strategies are similarly
complicated in this high-risk situation. The authors report a case of a full-term
parturient with a history of 2 prior cardiac surgeries who presented with a rapidly
growing aortic pseudoaneurysm. The authors describe the planned use of minimally invasive
procedures, including an endovascular aortic balloon (endo-balloon) for endo-occlusion
in case of pseudoaneurysm rupture, and a percutaneous coronary sinus catheter to provide
myocardial protection. These efforts facilitated successful pseudoaneurysm repair,
preserving the life of the mother and baby.Key Words
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Article info
Publication history
Published online: October 12, 2022
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