Surgery for Acute Type A Aortic Dissection in A Pregnant Woman At 28 Weeks’ Gestation

Kuroda, Yasuhiro; Uchida, Tetsuro; Hamasaki, Azumi; Yamashita, Atsushi; Mizumoto, Masahiro; Akabane, Kentaro; Ishizawa, Ai; Sadahiro, Mitsuaki

doi:10.21470/1678-9741-2018-0225

Cited by 4 publications

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References 3 publications

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“…The systematic literature search yielded 465 potentially eligible studies. After exclusion, cross‐referencing, and reaching an agreement on three authors, 80 studies were included in this systematic literature review 5–84 (Figure 1). This resulted in a total study of 103 patients with aortic dissection during 6 months before delivery to 12 weeks postpartum.…”

Section: Resultsmentioning

confidence: 99%

Aortic dissection during pregnancy and postpartum

Meng

Han

Wang

2021

Journal of Cardiac Surgery

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Background: Patients with aortic dissection during pregnancy and postpartum period exhibit a high mortality. At present, a complete overview of aortic dissection during pregnancy and postpartum period is lacking.Methods: This systematic review included 80 reports published from 2000 to 2020, comprising a total study population of 103 patients with aortic dissection.Results: We found that Stanford Type A aortic dissection was more common in prepartum cases, especially in the third trimester, while postpartum cases of aortic dissection were more common in Stanford Type B. The most common risk factor was connective tissue disease, with no other known risk factors. The mode of delivery had no significant effect on the type of postpartum aortic dissection. Reduced maternal and fetal mortality was observed when patients with Stanford Type A aortic dissection occurring after 28 gestational weeks underwent cesarean section followed by aortic replacement. Patients with Stanford Type B aortic dissection were treated mainly with medication and/or endovascular repair. Conclusion:Contemporary management of patients during pregnancy and within 12 weeks postpartum requires multidisciplinary cooperation and includes serial, noninvasive imaging, biomarker testing, and genetic risk profiling for aortopathy.Early diagnosis and accurate treatment are essential to reduce maternal and fetal mortality.

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Section: Resultsmentioning

confidence: 99%

Aortic dissection during pregnancy and postpartum

Meng

Han

Wang

2021

Journal of Cardiac Surgery

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Combined cesarean delivery and repair of acute type A aortic dissection at advanced pregnancy

Liu

Luo

et al. 2021

J Card Surg

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Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series

Peng

Deng

et al. 2021

Open Medicine

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In this study, a treatment method was assessed for the prevention and treatment of postpartum bleeding after combined surgery in patients having late pregnancy with the complication of acute Stanford type A aortic dissection. The clinical records of ten patients receiving treatment at the Second Xiangya Hospital of Central South University between March 2012 and March 2021 were retrospectively analysed. All patients were diagnosed with acute Stanford type A aortic dissection according to computed tomography angiography of the thoracic and abdominal aorta. Aortic valve function was assessed using two-dimensional echocardiography. All patients experienced uterine-incision delivery under systemic anaesthesia. During the operation, intrauterine Bakri balloon tamponade and cervical cerclage were performed. Postpartum bleeding was effectively controlled for all patients. The extracorporeal circulation time was 230–295 min, the postpartum 24 h bleeding volume was 500–870 mL, the volume of physiological saline injected into the balloon was 290–515 mL, and the intrauterine balloon compression time was 28–51 h. No postpartum bleeding occurred. A 42-days follow-up showed no late postpartum bleeding, poor uterine incision healing, or puerperal infection, and no uterine removal was performed. Intrauterine Bakri balloon tamponade plus cervical cerclage can effectively prevent intra- and postoperative postpartum bleeding in pregnant patients with aortic dissection.

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Surgery for Acute Type A Aortic Dissection in A Pregnant Woman At 28 Weeks’ Gestation

Cited by 4 publications

References 3 publications

Aortic dissection during pregnancy and postpartum

Aortic dissection during pregnancy and postpartum

Combined cesarean delivery and repair of acute type A aortic dissection at advanced pregnancy

Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series

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