Massive retrograde acute type B aortic dissection in a postpartum woman with a family history of Marfan syndrome

Gandhi, Sweeta D.; Iqbal, Zafar; Markan, Sandeep; Almassi, G. Hossein; Pagel, Paul S.

doi:10.1016/j.jclinane.2007.06.019

Cited by 18 publications

(12 citation statements)

References 15 publications

(26 reference statements)

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“…In a case report on a patient who developed a massive retrograde type B aortic dissection 7 days after normal spontaneous vaginal delivery, Gandhi et al described the patient as "petite" (body surface area, 1.69 m 2 ), but this is still larger than the average Japanese woman. 25 We also suggest that normalizing the diameter of the sinus of Valsalva with regard to body surface area (diameter of the Valsalva/body surface area; mm/m 2 ) may be more appropriate for detection of high-risk cases at the start of pregnancy. The relative aortic size was first used to predict complications in patients with thoracic aortic aneurysms.…”

Section: Discussionmentioning

confidence: 94%

“…This large increase relative to that in the Meijboom et al study 15 is probably due to the maternal cardiovascular changes in pregnancy, including increased blood volume, heart rate, and stroke volume. 25 Furthermore, hormonally mediated histological changes also occur in the aorta, including a decrease in mucopolysaccharides and loss of elastic fibers in the aortic wall. 26-28 Care is therefore required in treating patients with a high growth rate of the sinus of Valsalva.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy-Associated Aortic Dilatation or Dissection in Japanese Women With Marfan Syndrome

Katsuragi

Ueda

Yamanaka

et al. 2011

Circ J

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Background: Aortic dilatation and dissection are severe complications of pregnancy that may cause maternal death. The purpose of the present study was to investigate risk factors for aortic dilatation or dissection in pregnant Japanese women with Marfan syndrome. Methods and Results:A total of 28 patients with Marfan syndrome were investigated retrospectively during pregnancy and after delivery at 1 institution. These patients were divided into 2 groups: those who experienced aortic dilatation or dissection (group D, n=11) and those who did not (group ND, n=17). In group D, aortic dilatation or dissection occurred in 7 cases during pregnancy (2 in the 2 nd trimester, 5 in the 3 rd trimester) and 4 cases after birth. The 2 cases in the 2 nd trimester involved aortic dilatation >60 mm and those patients underwent hemiarch replacement and a David operation, respectively. Delivery by cesarean section (64% vs. 18%, P<0.05), sinus of Valsalva ≥40 mm (86% vs. 21%, P<0.05), aortic size index (size of sinus of Valsalva/body surface area) ≥25 mm/m 2 (7/7, 100% vs. 0/14, 0%, P<0.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Pregnancy-Associated Aortic Dilatation or Dissection in Japanese Women With Marfan Syndrome

Katsuragi

Ueda

Yamanaka

et al. 2011

Circ J

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“…Postpartum aort diseksiyonları sıklıkla 7. ile 33. gün-ler arasında rapor edilmektedir (1) . Olgumuzda ise doğumdan hemen sonra aort diseksiyonu tespit edilmiş-tir.…”

Section: Discussionunclassified

“…Peripartum dönemde gelişen aort diseksiyonun nedenleri arasında; sistemik hipertansiyon, aort kökünün genişlemesi, konjenital biküspit aort kapağı, Marfan Sendromu, Ehlers-Danlos sendromu sayıla-bilir (1,2) . Özellikle gebeliğe bağlı gelişen aort diseksiyonlarının yarısından Marfan Sendromu sorumlu tutulmaktadır (3,4) .…”

Section: Introductionunclassified

“…Gebelikte gözlenen taşikardi, kardiyak output ve intravasküler volüm artışı ve özellik-le üçüncü trimesterde uterusun distal aortaya ve iliak arterlere basısı sonrası proksimal aortada meydana gelen stres olası patofizyolojik nedenler arasındadır (5) . Ayrıca gebeliğe bağlı östrojen ve progesteron hormonlarının konsantrasyonlarındaki değişimler vasküler duvar yapısında değişikliğe neden olur, bu da hemodinamik güçlere duyarlılığı artırmaktadır (1) .…”

Section: Introductionunclassified

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