Korean J Leg Med.  2013 Aug;37(3):161-166. 10.7580/kjlm.2013.37.3.161.

Rupture of Ascending Thoracic Aortic Aneurysm in Postpartum: 2 Cases Report

• Kim A
• Ha H
• Park S

• KMID: 2305470
• DOI: http://doi.org/10.7580/kjlm.2013.37.3.161

Abstract

Thoracic aortic aneurysms are less common than abdominal aortic aneurysms, however they are life-threatening and usually asymptomatic until acute complications occur. The majority of thoracic aorta aneurysm are associated with medial degeneration rather than atherosclerosis and the fusiform aortic aneurysm is common. Considering that it usually occurs during the sixth and seventh decades of life, its occurrence in a peripartum woman is unusual. Aortic dissection or thoracic aortic aneurysm with aortic insufficiency during pregnancy or peripartum has been reported, however, to our knowledge, the case of ascending thoracic aortic aneurysm in peripartum women, with saccular type without aortic valve involvement but not diffuse dilatation, has not been reported. Herein, we presented two autopsy cases of ascending thoracic aortic aneurysm during postpartum.

Keyword

Thoracic aorta; Aneurysm; Peripartum

MeSH Terms

Aneurysm
Aorta, Thoracic
Aortic Aneurysm
Aortic Aneurysm, Abdominal
Aortic Aneurysm, Thoracic
Aortic Valve
Atherosclerosis
Autopsy
Dilatation
Female
Humans
Peripartum Period
Postpartum Period
Pregnancy
Rupture

Figure

• 

  Fig. 1. The saccular type aneurysm with rupture is observed on the ascending aorta and aortic wall cut longitudinally showing true aneurysm (Case 1).

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  Fig. 2. The ruptured aneurysm is identified on the ascending aorta, with localized mild atherosclerotic changes (Case 2).

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  Fig. 3. The wall of the aneurysm is extremely thin (a: H & E, × 100) compared with normal aortic wall (b: H & E, × 100), but is composed of all 3 layer of vessel wall. Immunohistochemical staining for smooth muscle actin is positive for myofibroblast in media, which support the aneurysm is a true aneurysm (c: SMA, × 200). Special stain for elastic fiber shows disrupted elastic laminae (d: elastin, × 200).

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