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2019, vol. 147, br. 3-4, str. 205-210
Trudnica preživela disekciju aorte, a kasnije umrla zbog koronarne embolije - jedinstven slučaj nesaradljivog bolesnika
Univerzitet u Novom Sadu, Medicinski fakultet + Univerzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti

e-adresaandrej.preveden@mf.uns.ac.rs
Ključne reči: disekcija aorte; trudnoća; antikoagulantna terapija; tromboza mehaničkog zaliska; koronarna embolija
Sažetak
Uvod Učestalost disekcije aorte se kreće između tri i pet slučajeva na 100.000 ljudi godišnje. Od žena mlađih od 40 godina koje dobiju disekciju aorte gotovo polovina su trudnice. Prikaz bolesnika Prikazan je slučaj 22-godišnje trudnice u 16. gestacijskoj nedelji sa istorijom arterijske hipertenzije i dilatiranom aortom, koja je primljena zbog disekcije aorte. Urađena joj je operacija po Bentalu, kojom su joj zamenjeni aortni zalistak, ascedentna aorta i proksimalni deo luka aorte korišćenjem kompozitnog grafta sa zaliskom. Plod nije preživeo operaciju, te je sutradan načinjena evakuaciona kiretaža. Šest godina kasnije kod bolesnice je, usled prestanka uzimanja antikoagulantne terapije, došlo do tromboze mehaničkog zaliska, koja je uspešno izlečena intravenskom primenom heparina. Posle godinu dana bolesnica je umrla zbog infarkta miokarda uzrokovanog koronarnom tromboembolijom, što je potvrđeno obdukcijom. Zaključak Kod žena sa poznatom bolešću aorte veoma je važno savetovanje pre začeća. Disekcija aorte kod trudnica je akutno, životno ugrožavajuće stanje kako za majku tako i za fetus, u čijem zbrinjavanju treba da učestvuje multidisciplinarni tim. Posle ugradnje mehaničkog zaliska neophodna je doživotna antikoagulantna terapija.
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O članku

jezik rada: engleski
vrsta rada: prikaz slučaja
DOI: 10.2298/SARH180521007P
objavljen u SCIndeksu: 07.07.2019.

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