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by Michael I. Brener, and Ali R. Keramati

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1 by Michael I. Brener, and Ali R. Keramati
Type B Dissection in a Pregnant Woman Managed With Peripartum Thoracic Endovascular Aortic Repair by Michael I. Brener, and Ali R. Keramati Circulation Volume 133(5):e369-e373 February 2, 2016 Copyright © American Heart Association, Inc. All rights reserved.

2 The initial computed tomography pulmonary angiogram on the day of presentation demonstrating a descending thoracic aortic dissection with the true lumen identified by arrows and the false lumen highlighted by arrowheads. The initial computed tomography pulmonary angiogram on the day of presentation demonstrating a descending thoracic aortic dissection with the true lumen identified by arrows and the false lumen highlighted by arrowheads. Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

3 A subsequent non–contrast-enhanced computed tomography of the abdomen 48 hours into the patient’s hospitalization demonstrating the dissection extending down the descending aorta (dissection plane marked by arrows). A subsequent non–contrast-enhanced computed tomography of the abdomen 48 hours into the patient’s hospitalization demonstrating the dissection extending down the descending aorta (dissection plane marked by arrows). The fetus is also visualized in the cephalic presentation. Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

4 A still frame from the transthoracic echocardiogram (suprasternal view) performed 48 hours after symptom onset. A still frame from the transthoracic echocardiogram (suprasternal view) performed 48 hours after symptom onset. Note the aortic arch, main branch vessels, and the dissection flap demarcated by the white arrow. Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

5 A still frame from the echocardiogram performed 48 hours after symptom onset with color-flow Doppler applied to the suprasternal view. A still frame from the echocardiogram performed 48 hours after symptom onset with color-flow Doppler applied to the suprasternal view. Preserved flow is demonstrated in the true lumen, with absent flow seen in the false lumen. Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

6 Intraprocedural aortogram still frame outlining the aortic arch and its tributaries, with an endovascular stent deployed immediately distal to the takeoff of the left subclavian artery. Intraprocedural aortogram still frame outlining the aortic arch and its tributaries, with an endovascular stent deployed immediately distal to the takeoff of the left subclavian artery. Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

7 Computed tomography images performed at the 3-month follow-up.
Computed tomography images performed at the 3-month follow-up. The endovascular graft can be visualized immediately distal to the takeoff of the left subclavian artery (A; white arrow marks the graft) and has remained patent (B). Postprocessing images of the abdominal aorta demonstrate the dissection plane extending to the aortic bifurcation, with the true (arrow) and false (arrowhead) lumens side by side (C and D). Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

8 Computed tomography images performed at the 9-month follow-up.
Computed tomography images performed at the 9-month follow-up. The endoprosthesis is visualized (A and B), as well as the dissection plane in cross section, with persistent filling of the true and false lumens in the descending thoracic aorta (C) and the abdominal aorta (D). Michael I. Brener, and Ali R. Keramati Circulation. 2016;133:e369-e373 Copyright © American Heart Association, Inc. All rights reserved.

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