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- Title
Aortic dissection in the first trimester; is it a dead end? A narrative review of recent articles.
- Authors
Ayati, Aryan; Sarraf, Syna; Asl Fallah, Sahar; Bagheri, Jamshid; Ahmadi Tafti, Hossein; Same, Kaveh; Hosseini, Kaveh
- Abstract
Introduction: Acute‐type aortic dissection (AD) during pregnancy is considered a rare and potentially fatal complication for both mother and fetus. Although the definite treatment for an acute‐type AD is considered to be open‐heart surgery, the decision to perform such a surgery during pregnancy requires a multidisciplinary approach and carries significant risks. Methods: In the present review of the literature, we have discussed various challenges in the management of acute‐type AD during pregnancy, including therapeutic approaches, choosing the preferred imaging modalities, surgical techniques, and medication challenges. We have also reported an 8‐week pregnant woman with Marfan syndrome who presented with chest pain and was diagnosed with acute AD. Results: The patient underwent a Bentall operation and was discharged in good condition with her fetus alive. The medical team's various decisions during preoperative, operative, and postoperative treatments were discussed. Conclusions: Type A AD is considered infrequent in the second and third trimester of pregnancy and rare in the first trimester. Performing a CMR study without contrast in stable patients can help evaluate the extension of the flap. Urgent surgery in the hands of a skilled surgeon may prove lifesaving for the mother while maximizing the likelihood of preserving the fetus.
- Publication
Journal of Cardiac Surgery, 2022, Vol 37, Issue 6, p1705
- ISSN
0886-0440
- Publication type
Article
- DOI
10.1111/jocs.16451