Aortic dissection complicating pregnancy following prophylactic aortic root replacement in a woman with Marfan syndrome

McDermott, Colleen D.; Sermer, Mathew; Siu, Samuel C.; David, Tirone E.; Colman, Jack M.

doi:10.1016/j.ijcard.2006.09.023

Cited by 28 publications

(22 citation statements)

References 19 publications

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“…A pregnancy can be made because of the increase in heart rate, stroke volume, cardiac output, and end-diastolic dimensions during pregnancy [1-3]. These changes and aortic dissection occur most often during the third trimester [4,5]. During pregnancy, the uterus compresses both the aorta and iliac artery, causing an increase in the vessel outflow resistance [1].…”

Section: Discussionmentioning

confidence: 99%

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

Lee

Jung

Lee

2012

Korean J Thorac Cardiovasc Surg

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Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

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Section: Discussionmentioning

confidence: 99%

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

Lee

Jung

Lee

2012

Korean J Thorac Cardiovasc Surg

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“…An increased risk of aortic dissection or rupture has been well described in women with an aortic root diameter >40 to 45 cm and for those with previous aortic root surgery. 110,111 This risk of aortic complications increases throughout the pregnancy, and complications may also occur after delivery. The risk is low for aortic diameters <4.0 cm but pregnancy is absolutely contraindicated in women with an aortic root diameter >4.4 cm and surgical repair of the aortic root is recommended before pregnancy for aortic root diameters >4.0 to 4.5 cm.…”

Section: Marfan Syndromementioning

confidence: 99%

“…The risk is low for aortic diameters <4.0 cm but pregnancy is absolutely contraindicated in women with an aortic root diameter >4.4 cm and surgical repair of the aortic root is recommended before pregnancy for aortic root diameters >4.0 to 4.5 cm. 21,47,111 Other congenital aortopathies such as Loeys-Dietz have been identified which also place patients at increased risk of aortic complications, requiring careful management. The risk for dissection may vary according to the specific type of aortopathy, and special expertise in these disorders is required to counsel women about their pregnancy risk and outcomes.…”

Section: Marfan Syndromementioning

confidence: 99%

Cardiovascular Management in Pregnancy

Brickner

2014

Circulation

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“…We identified 18 relevant articles including a total of an additional 19 patients with MFS whose pregnancy was complicated by type B-AD between 1983 and 2008 (Table 1) [3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Review Of the Literaturementioning

confidence: 99%

Stanford type B aortic dissection associated with pregnancy in patients with Marfan syndrome—A case report and review of the literature

Nishino

Suda

Kuramaoto

et al. 2010

Journal of Cardiology Cases

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A 36-year-old female patient known to have Marfan syndrome (MFS) presented with Stanford type B aortic dissection (type B-AD) 3 days after delivery although she had taken oral ␤-blocker and underwent prophylactic cesarean section at 34 weeks when she showed 42 mm of the ascending aorta. She was successfully treated medically without further progression of the dissection. A review of the literature revealed an additional 19 patients with MFS who suffered from type B-AD associated with pregnancy. Of 20 patients, 1 (5%) died but the remaining 19 patients were successfully treated either medically (n = 9) or surgically (n = 10). Of 13 patients whose aortic diameter was known, 5 showed <40 mm of the ascending aorta. Pregnancy in MFS can be complicated by type B-AD with a peak around term delivery irrespective of the size of ascending aorta and even with ␤-blocker.

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Aortic dissection complicating pregnancy following prophylactic aortic root replacement in a woman with Marfan syndrome

Cited by 28 publications

References 19 publications

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

Cardiovascular Management in Pregnancy

Stanford type B aortic dissection associated with pregnancy in patients with Marfan syndrome—A case report and review of the literature

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