Successful repair of a ruptured Stanford type B aortic dissection during pregnancy

Stout, Chris E.; Scott, Eric C.; Stokes, Gordon K.; Panneton, Jean M.

doi:10.1016/j.jvs.2009.10.121

Cited by 19 publications

(14 citation statements)

References 9 publications

(6 reference statements)

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“…The literature retrieval yielded 96 reports, comprising 85 case reports and 11 case series or original articles, with 122 patients . Mean patient age (n = 120) was 31.6 ± 4.7 years (range, 19–43 years; median, 31.5 years) on admission.…”

Section: Resultsmentioning

confidence: 99%

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

Yuan

2013

Clinical Cardiology

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Aortic dissection (AoD) during pregnancy is a rare but lethal condition and highlights the need for extensive elucidation. The aim of this study is to reveal the risk factors for AoD during pregnancy and to compare the 2 main risk factors, Marfan syndrome and pregnancy itself in the previously healthy woman. The pregnant patients developed AoD at 31.7 ± 7.6 weeks of gestation. It occurred much earlier in the Marfan patients than in the previously healthy women (30.7 ± 8.6 weeks of gestation vs 34.4 ± 4.4 weeks of gestation, P = 0.0263). In the Marfan patients, AoD developed in 3 (3.2%), 15 (15.8%), and 43 (46.3%) patients in the 3 trimesters, respectively, compared with 31 of the previously healthy women, and only in the third trimester. The neonates of the Marfan patients had better Apgar scores at 1 and 5 minutes, lower intubation rates, and fewer stays in the neonatal intensive care unit than those of the previously healthy women. Marfan syndrome and pregnancy itself in the previously healthy woman were the 2 main risk factors responsible for the occurrence of AoD during pregnancy. Marfan patients may develop AoD at an early age and an early stage of pregnancy, probably due to the preexisting weakened aortic wall. Better outcomes for the surviving neonates of Marfan patients compared with neonates of the previously healthy women might be the result of the poor condition of Marfan patients causing a higher death rate for those fetuses.

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Section: Resultsmentioning

confidence: 99%

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

Yuan

2013

Clinical Cardiology

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“…El tratamiento quirúrgico está indicado en casos con aumento de la dilatación aneurismática, ruptura inminente, síndrome de hipoperfusión por oclusión de ramas y dolor agudo refractario (27,32).…”

Section: Discussionunclassified

Disección aórtica tipo B y embarazo en un síndrome de Marfán: manejo y resultado

Llancaqueo

et al. 2012

Rev. chil. obstet. ginecol.

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“…We identified 50 articles that fit our inclusion criteria (41 solitary cases and 9 case series) . The 50 articles yielded a total of 72 patients who met the inclusion criteria (AAD during pregnancy or within 1 year postpartum).…”

Section: Methodsmentioning

confidence: 99%

Pregnancy-related acute aortic dissection in Marfan syndrome: A review of the literature

Smith

Gros

2017

Congenital Heart Disease

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A well-established association exists between acute aortic dissection and pregnancy, particularly in women with Marfan syndrome. However, there is debate regarding appropriate management guidelines. In particular, there are differing opinions regarding when prophylactic aortic root repair should be recommended as well as the efficacy of beta blockers in this clinical scenario. The current study evaluated 10 years of published literature (2005-2015) in the PubMed/Medline database. Fifty articles, describing 72 cases of women who presented with aortic dissection in the antepartum or postpartum period were identified. Comparisons on demographic variables and clinical outcomes between cases of women with Marfan syndrome (n = 36) and without Marfan syndrome (n = 36) were conducted. There were no significant differences in demographics (age, gravidity, parity) between the Marfan and non-Marfan cases. Marfan patients presented with antepartum dissections significantly earlier in pregnancy than those without Marfan syndrome (P = .002). However, there were no significant difference between the 2 groups in maternal mortality, fetal mortality, or obstetric outcomes (mode of delivery and gestational age at delivery). Eight cases described events in Marfan women with an aortic root diameter ≤40 mm. Six events occurred in Marfan women who were managed with beta blockers. Current guidelines rely on aortic root diameter for stratification of Marfan women into risk categories, but we identified several cases that would be missed by these guidelines. Specifically, the existing literature suggest that women with Marfan syndrome should take precautions throughout pregnancy, rather than the third trimester.

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Successful repair of a ruptured Stanford type B aortic dissection during pregnancy

Cited by 19 publications

References 9 publications

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

Aortic Dissection During Pregnancy: A Difficult Clinical Scenario

Disección aórtica tipo B y embarazo en un síndrome de Marfán: manejo y resultado

Pregnancy-related acute aortic dissection in Marfan syndrome: A review of the literature

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