Personalized External Aortic Root Support Before Pregnancy in Heritable Thoracic Aortic Disease

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  Visual Summary. Personalized External Aortic Root Support Before Pregnancy in Heritable Thoracic Aortic Disease Clinical course of 2 women with HTAD undergoing PEARS before pregnancy. Across 3 pregnancies, aortic dimensions remained stable with no dissections. All deliveries were term vaginal births, complicated by postpartum hemorrhage. Follow-up demonstrated stable aortic dimensions, supporting PEARS as a potential valve-preserving option in selected patients. FTAAD = familial thoracic aortic aneurysm and dissection; HTAD = heritable thoracic aortic disease; PEARS = personalized external aortic root support.

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  Figure 1. PEARS Prosthesis A microporous, compliant polyester mesh sleeve designed to cease aortic dilatation and preserve aortic valve function. The sleeve is patient-specific and is fabricated using 3-dimensional reconstructions of the aorta derived from computed tomography (CT) or magnetic resonance imaging (MRI) data. BCA = brachiocephalic artery; LCA = left coronary artery; PEARS = personalized external aortic root support; RCA = right coronary artery. Reproduced with permission from the eXstent website.

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  Figure 2. PEARS In Situ The sleeve is positioned circumferentially around the aortic root and proximal ascending aorta during surgery. PEARS = personalized external aortic root support.

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  Figure 3. CT Imaging of the Aorta Before and After PEARS in 2 Patients With HTAD Representative CT images demonstrating aortic dimensions in patient 1 (A) pre-PEARS and (B) post-PEARS, and in patient 2 (C) pre-PEARS and (D) post-PEARS. CT = computed tomography; HTAD = heritable thoracic aortic disease; PEARS = personalized external aortic root support.