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成功剖宫产术后行血管内支架植入术治疗36周双胎妊娠合并急性主动脉夹层:一例报告

A successful cesarean section followed with endovascular stent-graft implantation for a 36-week twin pregnancy with acute aortic dissection: a case report.

作者信息

Hao Qun, Wang Hao, Zhang Cheng, Ma Ai-Qing, Wu Yuan-Zhe

机构信息

Department of Obstetrics and Gynecology, Jinling Hospital, School of Medicine, Nanjing University, Zhongshan East Road #305, Nanjing, 210002, Jiangsu, China.

Department of General Surgery, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, Zhongshan Road #321, Nanjing, 210002, Jiangsu, China.

出版信息

Ir J Med Sci. 2016 Aug;185(3):735-739. doi: 10.1007/s11845-015-1260-2. Epub 2015 Feb 3.

DOI:10.1007/s11845-015-1260-2
PMID:25644698
Abstract

INTRODUCTION

It is a first case report for a woman pregnant with twins who suddenly ruptured with a Stanford type B aortic dissection.

MATERIALS AND METHODS

A 24-year-old pregnant patient gravida 1 and para 0 at the 36th gestation week was sent to our Emergency Department under the medical monitoring by the local gynecologist. Her primary complaints were that she suddenly felt "severe tearing chest pain". Ultrasound image illustrated fetal twins at cephalic positions about 36th gestation week. An emergent magnetic resonance angiography (MRA) of aorta is given below: dissection of the descending aorta arisen from the descending aorta to the bifurcation of abdominal aorta suggestive of Stanford type B aortic dissection.

RESULTS

The two babies were delivered by an emergent cesarean section and stent-graft placement of the descending thoracic aorta was performed on the mother thereafter.

CONCLUSION

This case report illustrates the value of comprehensive multidisciplinary discussion and collaboration among different departments to make quick decisions. Endovascular stent-graft repair may be the best option for the treatment of Stanford type B aortic dissection in late pregnancy.

摘要

引言

这是首例关于怀有双胞胎的女性突然发生斯坦福B型主动脉夹层破裂的病例报告。

材料与方法

一名24岁、孕1产0、妊娠36周的孕妇在当地妇科医生的医疗监护下被送往我院急诊科。她的主要主诉是突然感到“剧烈的撕裂样胸痛”。超声图像显示为妊娠约36周、头位的双胞胎胎儿。以下是主动脉的急诊磁共振血管造影(MRA):降主动脉夹层从降主动脉延伸至腹主动脉分叉处,提示为斯坦福B型主动脉夹层。

结果

通过急诊剖宫产分娩出两个婴儿,随后对母亲进行了降胸主动脉覆膜支架置入术。

结论

本病例报告说明了不同科室之间进行全面多学科讨论与协作以迅速做出决策的价值。血管内覆膜支架修复术可能是妊娠晚期斯坦福B型主动脉夹层治疗的最佳选择。

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