Acute Aortic Dissection in Pregnancy with the Marfan Syndrome

Kim, Si Wook; Kim, Dohun; Hong, Jong-Phil

doi:10.5090/kjtcs.2014.47.3.291

Cited by 11 publications

(8 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…У пациентов с синдромом Марфана дегенеративно-дистрофические изменения соединительной ткани ассоциированы в том числе с дилатацией корня и всех элементов восходящего отдела аорты. Гормональная перестройка, увеличение объема циркулирующей крови, аортокавальная компрессия у беременных женщин с этим заболеванием на фоне существующей компрометации соединительной ткани увеличивают риск летального исхода вследствие диссекции и разрыва аорты во II и особенно в III триместрах беременности [3]. В зависимости от исходного размера корня аорты частота подобного угрожающего жизни осложнения составляет до 50% в III триместре беременности и около 30% после родоразрешения [4].…”

Section: Discussionunclassified

Valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of pregnancy

Bazylev

Rosseykin

Евдокимов

et al. 2018

Khir. Z. im. N.I. Pirogova

View full text Add to dashboard Cite

The article presents a clinical case of valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of gestation followed by successful prolongation of pregnancy. Indications for reconstructive intervention with cardiopulmonary bypass were: severe aortic valve insufficiency, Sinus of Valsalva Aneurysm (66 mm) and the ascending aorta dilatation (53 mm) with a rapid increase of aortic root dimension (12 mm during 9 weeks). The patient underwent a valve sparing aortic root replacement according to David procedure using Gelweave Valsalva graft (Vascutec) No 28 The time of cardiopulmonary bypass was 137 minutes; the time of aortic cross-clamping was 107 minutes. The patient was discharged from the hospital in a satisfactory condition in 21 days after the operation. Pregnancy was prolonged and ended with a planned cesarean section at 38 weeks of gestation, the birth of a boy with an Apgar score of 7/8.

show abstract

Section: Discussionunclassified

Valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of pregnancy

Bazylev

Rosseykin

Евдокимов

et al. 2018

Khir. Z. im. N.I. Pirogova

View full text Add to dashboard Cite

show abstract

“…In acute aortic dissection (AD) in pregnancy, increased cardiovascular stress due to pregnancy is an important factor leading to an emergent aortic event ( 1 , 2 ). It is very rare with an annual incidence rate of 5.5 per million maternities in the US (among 6,566,826 pregnancies in 4,933,697 females) and 0.5 per million maternities in Europe (341,381 females were followed up after 10 years) ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Type A aortic dissection in pregnant patients with fibrillin‑1 gene mutations: Two case reports and a literature review

et al. 2018

View full text Add to dashboard Cite

In acute aortic dissection (AD) in pregnancy, increased cardiovascular stress due to pregnancy is an important factor leading to an emergent aortic event. It is rare but often results in a devastating event for both the pregnant patient and the foetus. Two cases of acute AD (Stanford type A) in pregnant females are presented in the present study. The patients were diagnosed via echocardiography, and the diagnosis was confirmed with computed tomography angiography prior to aortic surgery. Up to 50% of ADs in pregnancy occur in patients with fibrillin-1 (FBN1) gene mutations. The FBN1 gene was sequenced in both patients, and notable, novel pathogenic mutations of FBN1 were identified in both patients. A literature review was also performed on available diagnostic imaging and other measurements regarding AD during pregnancy. The authors suggest that the relevant content may have important clinical implications in raising disease awareness, arranging test rationally and choosing an intervention method.

show abstract

“…Pregnancy with MFS presents challenges to the clinician because of the increased incidence of maternal cardiovascular complications and the involvement of the fetus owing to the urgency of the need for surgery and the low likelihood of survival with premature delivery. Acute aortic dissection (AAD) during pregnancy can be fatal to both the pregnant mother and the baby, particularly in patients with MFS . Pregnant women with MFS thus need particular attention, because of the high risk for aortic dilation or dissection during and after pregnancy .…”

Section: Introductionmentioning

confidence: 99%

“…The first review of pregnancy‐associated cardiovascular risk in MFS proposed a threshold of aortic root diameter 40 mm before pregnancy as a cut‐off for the stratification of women into low (1%) and increased risk (10%) for dissection . This threshold of 40 mm has been widely debated in other papers, but the current European guidelines for the management of cardiovascular diseases during pregnancy still adopt this value …”

Section: Introductionmentioning

confidence: 99%

Intra‐ and post‐partum acute aortic dissection (Stanford type B): Report of two cases

Tsuritani

Kamiya

Sawada

et al. 2017

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Pregnancy with Marfan syndrome (MFS) presents challenges to the clinician because of the increased incidence of maternal cardiovascular complications, including acute aortic dissection (ADD) and the involvement of the fetus owing to the urgency of the need for surgery and the low likelihood of survival with premature delivery. Patient 1 was a 36-year-old pregnant Japanese woman with MFS who was referred at 16 gestational weeks with aortic root diameter 35.1 mm. Stanford type B AAD occurred on delivery without evident blood pressure changes. Patient 2 was a 31-year-old pregnant Japanese woman with MFS with aortic root diameter 28.3 mm at 20 gestational weeks after David procedure. Ultimately fatal Stanford type B AAD occurred on post-partum day 15. Both patients were treated with beta-blockers when AAD occurred. Although these two patients were initially considered to have relatively low risk according to previous reports and guidelines, AAD occurred. It is very important to provide information about these high pregnancy risks to women with MFS before conception, and to follow MFS pregnancies with great caution.

show abstract

Acute Aortic Dissection in Pregnancy with the Marfan Syndrome

Cited by 11 publications

References 7 publications

Valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of pregnancy

Valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of pregnancy

Type A aortic dissection in pregnant patients with fibrillin‑1 gene mutations: Two case reports and a literature review

Intra‐ and post‐partum acute aortic dissection (Stanford type B): Report of two cases

Contact Info

Product

Resources

About