Spontaneous left main coronary artery dissection in pregnancy

Sharma, Naveen; Seevanayagam, Siven; Rayoo, R.; Grace, R. Randall; Gleeson, Geoffrey; Anavekar, Nagesh S.; Barlis, Peter

doi:10.1016/j.ijcard.2011.11.016

Cited by 10 publications

(2 citation statements)

References 14 publications

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“…Exclusion of duplicate results and articles not meeting specified a priori criteria (162 articles) resulted in 111 articles describing 138 cases of P-SCAD [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47], [48], [49], [50], [51], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77], [78], [79], [80], [81], [82], [83], [84], [85], [86], [87], [88], [89], …”

Section: Methodsmentioning

confidence: 99%

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Paratz

Kao

MacIsaac

et al. 2018

IJC Heart & Vasculature

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BackgroundPregnancy-associated spontaneous coronary artery dissection (P-SCAD) is defined as SCAD occurring during pregnancy or within 3 months post-partum. Earlier systematic reviews have suggested a high maternal and foetal mortality rate. We undertook a structured systematic review of P-SCAD demographics, management and maternal and foetal outcomes.MethodsCase study identification was conducted according to PRISMA guidelines, with screening of all published P-SCAD cases not meeting pre-defined exclusion criteria. Of two hundred and seventy-three publications screened, one hundred and thirty-eight cases met inclusion criteria. Cases were allocated to one of three time periods; 1960–85 (twenty cases) reflecting early management of P-SCAD, 1986–2005 (forty-two cases) reflecting recent management, and 2006–16 (seventy-six cases), reflecting contemporary management.ResultsThe only significant demographic change in women experiencing P-SCAD over the last 50 years was an increasing proportion of primigravidas (p = 0.02). Management and outcomes, however, have altered significantly. Emergent angiography (p < 0.0001), reduced thrombolysis (p = 0.006) and increasingly conservative or percutaneous management (p < 0.0001) are associated with dramatic reductions in maternal mortality (85% in earliest reports to 4% in the last decade, p < 0.0001) and foetal mortality (50% in earliest reports to 0.0% in the last decade, p = 0.023).ConclusionThis systematic review of temporal changes in presentation, management and outcomes of P-SCAD represents the widest range of variables analysed in the largest cohort of P-SCAD patients to date. In the setting of earlier coronary angiography and increasingly conservative management, maternal and foetal survival rates continue to improve.

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Section: Methodsmentioning

confidence: 99%

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Paratz

Kao

MacIsaac

et al. 2018

IJC Heart & Vasculature

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“…Excess progesterone levels during pregnancy have been suggested to, very rarely, predispose women to dissection by causing fragmentation and loss of elasticity in vessel wall fibres (Sharma et al , ). As the dissection develops it creates a ‘false lumen’ for blood flow.…”

Section: Introductionmentioning

confidence: 99%

Post‐partum spontaneous coronary artery dissection and the use of veno‐arterial extra‐corporeal membrane oxygenation

Evans

2014

Nursing in Critical Care

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CT Imaging of Coronary Arteries

Porcu

Francone

Argiolas

et al. 2015

3D Imaging Technologies in Atherosclerosis

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Spontaneous left main coronary artery dissection in pregnancy

Cited by 10 publications

References 14 publications

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Evolving management and improving outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD): a systematic review

Post‐partum spontaneous coronary artery dissection and the use of veno‐arterial extra‐corporeal membrane oxygenation

CT Imaging of Coronary Arteries

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