Open surgical repair of an abdominal aortic aneurysm during the second trimester of pregnancy

Abstract

A 37-year-old obese woman, trigravida and secundiparous, at 17 weeks of gestation presented with acute abdominal pain. Doppler ultrasound examination showed an infrarenal abdominal aortic aneurysm measuring 61 mm in diameter and a computed tomography angiography outlined a fissured infrarenal aneurysm measuring 85 mm in diameter. To preserve the pregnancy, the obstetrician performed perioperative tocolysis. Subsequently, open surgery was conducted using open repair with 60 minutes of infrarenal cross-clamping. The postoperative course was uneventful, and the patient was discharged on day 10. She subsequently gave birth to a healthy baby at full term.

Keywords: Abdominal aortic aneurysm; Open surgery; Pregnancy; West Africa.

Fig 1

(A) Axial view of angio-computed tomography (CT) scan showing a large abdominal aortic aneurysm (AAA) (left) and two-dimensional MPR reconstruction (right). (B) Intraoperative view of the AAA (upper left corner) before “mise-à-plat” (lower left corner) and interposition of a 22-mm Dacron graft (right).

Fig 2

Six-month postoperative angio-computed tomography (CT) scan showing a patent graft and significant enlargement of the visceral aorta above the reconstruction.