11/232. Treatment of acute myocardial infarction in pregnancy with coronary artery balloon angioplasty and stenting.Acute myocardial infarction in pregnancy is a rare condition with substantial risk of maternal and fetal mortality. We present a case of myocardial infarction during pregnancy which was treated by percutaneous coronary artery balloon angioplasty and stenting with excellent pregnancy outcome.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
12/232. Novel mutation (E113X) of antithrombin iii gene (AT3) in a woman with gestational recurrent thrombosis.A 35-year-old Japanese woman with a low level (42-54%) of blood antithrombin (AT) III, experienced two induced abortions due to deep venous thrombosis at 8 weeks of gestation (GW) and cerebral thrombosis at 10 GW. The present pregnancy was successfully managed with intravenous administration of AT III (6,000-8,000 U/wk). Analysis of polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) for exons 3A and 4 of the AT III gene (AT3) using her dna revealed extra expansion bands with altered migration. The dna sequencing demonstrated novel mutations in exon 3A of AT3: a G to T substitution at nucleotide position 5333 in codon GAG for Glu 113, causing a stop codon (E113X), and an A to T substitution at position 5338 in codon AAA for Lys 114, forming Asn (K114N). These novel mutations, especially E113X, in AT3 may be related to recurrent thrombosis in the pregnancy.- - - - - - - - - - ranking = 0.00054873978546771keywords = single (Clic here for more details about this article) |
13/232. Femorofemoral bypass, even in pregnancy--a case report.A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.- - - - - - - - - - ranking = 0.2keywords = artery (Clic here for more details about this article) |
14/232. Innominate arterial rupture distal to anomalous origin of left carotid artery.Isolated innominate arterial rupture from blunt trauma is rare. We present the case of a pregnant woman with an isolated injury to the innominate artery distal to an anomalous origin of the left common carotid artery. A safe operative technique is described.- - - - - - - - - - ranking = 1.2keywords = artery (Clic here for more details about this article) |
15/232. Unstable angina during pregnancy in two patients with premature coronary atherosclerosis and aortic stenosis in association with familial hypercholesterolemia.Obstructive atherosclerotic coronary artery disease is uncommon in women during childbearing age, and the occurrence of myocardial ischemia during pregnancy has therefore been anecdotal. Two young patients with premature coronary artery disease in association with familial hypercholestrolemia had unstable angina in the second trimester of pregnancy. Workup revealed coronary artery disease and aortic stenosis. One patient opted for abortion at the twentieth week of gestation, and the other decided to continue pregnancy and was delivered by cesarean at 28 weeks' gestation. coronary artery bypass grafting was performed after pregnancy in both patients. In addition, one of the patients underwent aortic valve replacement, and other had replacement of the narrowed ascending aorta with uneventful recovery. Our report describes an uncommon presentation of unstable angina during pregnancy in 2 young women with premature coronary artery disease and aortic valvular and supravalvular stenosis as a result of familial hypercholesterolemia. The management of these conditions during pregnancy is influenced by the effects of available therapeutic modalities on both maternal and fetal outcome.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
16/232. Internal carotid artery pseudoaneurysm related to pregnancy.Arterial rupture is a common cause of maternal death. The increased tendency of true and false aneurysms to develop or rupture with advancing gestational age suggests that hemodynamic, hormonal, or other physiologic changes of pregnancy may play a role in their formation. To our knowledge, pseudoaneurysm formation from a carotid dissection or a ruptured true aneurysm related to pregnancy has not been previously reported. We report the successful repair of a large extracranial internal carotid artery pseudoaneurysm related to pregnancy. The clinical presentation, diagnostic modalities, surgical exposure, and treatment options for high internal carotid artery aneurysms will be discussed.- - - - - - - - - - ranking = 1.2keywords = artery (Clic here for more details about this article) |
17/232. Endovascular treatment of cerebral artery aneurysms during pregnancy: report of three cases.Historically, surgical management of cerebral aneurysms during pregnancy has been controversial. Debate originally focused on early versus late intervention, before or after delivery of the fetus. More recently, treatment has centered on rapid intervention. We describe the endovascular treatment of cerebral artery aneurysms with Guglielmi detachable coils in three pregnant women.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
18/232. Placenta percreta with bladder invasion as a cause of life threatening hemorrhage.PURPOSE: Abnormal placental penetration through the myometrium with bladder invasion is a rare obstetric complication with potential for massive blood loss. Urologists are usually consulted after a life threatening emergency has already arisen. Their familiarity with this condition is crucial for effective management. We describe 2 cases of placenta percreta with bladder invasion to highlight the catastrophic nature of this clinical entity, and review the literature on current diagnostic and management strategies. MATERIALS AND methods: Between 1986 and 1998, 250 cases of adherent placenta (0.9%) were identified in 25,254 births at our institution, including 2 (0.008%) of placenta percreta with bladder invasion. We treated these 2 multiparous women who were 33 and 30 years old, respectively. Each had undergone 2 previous cesarean sections. RESULTS: Presenting symptoms were severe hematuria in 1 patient and prepartum hemorrhage with shock in the other. Ultrasound showed complete placenta previa in each with evidence of bladder invasion in 1 patient. hysterectomy, bladder wall resection and repair, and bilateral internal iliac artery ligation were required to control massive intraoperative hemorrhage. The patients received 22 and 15 units of packed red blood cells, respectively. fetal death occurred in each case. convalescence was complicated by disseminated intravascular coagulation in patient 1 but subsequent recovery was uneventful. CONCLUSIONS: A high index of suspicion for placenta percreta with bladder invasion is required when evaluating pregnant women with a history of cesarean delivery and placenta previa who present with hematuria and lower urinary tract symptoms. ultrasonography and magnetic resonance imaging may assist in establishing the diagnosis preoperatively. With proper planning and a multidisciplinary approach fetal and maternal morbidity and mortality may be decreased.- - - - - - - - - - ranking = 0.2keywords = artery (Clic here for more details about this article) |
19/232. uterine artery pseudo-aneurysm: diagnosis and therapy during pregnancy.Arterial aneurysms and pseudo-aneurysms are a rare but recognized cause of obstetric hemorrhage. diagnosis during pregnancy, prior to rupture, is exceptional. We report the first case of diagnosis and treatment of an uterine artery pseudo-aneurysm during pregnancy.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
20/232. Low-density lipoprotein apheresis therapy during pregnancy.Pregnancy in patients with severe hypercholesterolemia and coronary artery disease results in multiple problems both for mother and fetus; the most potent agents for low-density lipoprotein (LDL) cholesterol reduction, the HMG-CoA reductase inhibitors (statins) cannot be used during pregnancy. We present a case in which LDL apheresis via heparin-induced extracorporeal LDL precipitation was employed safely and efficaciously during pregnancy in a woman with heterozygous familial hypercholesterolemia and stable coronary artery disease.- - - - - - - - - - ranking = 0.4keywords = artery (Clic here for more details about this article) |
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