| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1997;64:1345-1348
© 1997 The Society of Thoracic Surgeons
Departments of Cardiopulmonary Surgery and Gynecology and Obstetrics, St. Antonius Hospital, Nieuwegein, the Netherlands
Accepted for publication May 23, 1997.
Background. Acute aortic dissection occurring during pregnancy represents a lethal risk to both the mother and fetus. Our purpose was to study the prevalence, treatments, and outcome of this rare problem and to suggest therapeutic guidelines.
Methods. During the past 12 years, 6 pregnant women were admitted with an acute aortic dissection. Four had a type A and 2 had a type B dissection (Stanford classification).
Results. Two of the 4 patients with a type A dissection underwent a combined emergency operation consisting of first cesarean section and then ascending aortic repair. Cesarean section was carried out 5 days after the emergency procedure on the aorta in the third patient, and 16 weeks later in the fourth patient. All 4 fetuses were delivered alive. One fetus died 6 days later, but the other 3 are alive and well at long-term follow-up. Of the 2 patients with a type B dissection, 1 was operated on for celiac ischemia; the other was treated medically. In both cases the fetus died in utero. There were no maternal deaths in either group.
Conclusions. Cesarean section with concomitant aortic repair is recommended for pregnant women with a type A dissection, depending on the gestational age. The maternal hemodynamic status will determine the sequence of the two procedures. Medical treatment is advised for patients with a type B dissection, but surgical repair is indicated if complications such as bleeding or malperfusion of major side branches occur.
This article has been cited by other articles:
|
|
 |
|
  S. Pagni, B. L. Ganzel, and T. Tabb Hemiarch aortic replacement for acute type A dissection in a Marfan patient with twin pregnancy Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 740 - 741. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Radermecker, R. Durieux, J.-L. Canivet, and R. Limet Metachronous type III and type II acute aortic dissections in puerperium Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 541 - 543. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tilak, J. Smith, D. Rogers, P. Fox, M. Muntazar, and M. Peyton Successful near-term pregnancy outcome after repair of a dissecting thoracic aortic aneurysm at 14 weeks gestation: [Denouement heureux d'une grossesse menee presque a terme a la suite de la reparation d'un anevrysme dissequant de l'aorte thoracique a 14 semaines de gestation] Can J Anesth, December 1, 2005; 52(10): 1071 - 1075. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sakaguchi, H. Kitahara, T. Seto, T. Furusawa, D. Fukui, N. Yanagiya, K. Nishimura, and J. Amano Surgery for acute type A aortic dissection in pregnant patients with Marfan syndrome Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 280 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Meijboom, F. E. Vos, J. Timmermans, G. H. Boers, A. H. Zwinderman, and B. J.M. Mulder Pregnancy and aortic root growth in the Marfan syndrome: a prospective study Eur. Heart J., May 1, 2005; 26(9): 914 - 920. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Lewis, I. Ryder, and A. T. Lovell Peripartum presentation of an acute aortic dissection Br. J. Anaesth., April 1, 2005; 94(4): 496 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ray, G. J. Murphy, and L. E. Shutt Recognition and management of maternal cardiac disease in pregnancy Br. J. Anaesth., September 1, 2004; 93(3): 428 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Nienaber, R. Fattori, R. H. Mehta, B. M. Richartz, A. Evangelista, M. Petzsch, J. V. Cooper, J. L. Januzzi, H. Ince, U. Sechtem, et al. Gender-Related Differences in Acute Aortic Dissection Circulation, June 22, 2004; 109(24): 3014 - 3021. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Weissmann-Brenner, R. Schoen, and M. Y. Divon Aortic Dissection in Pregnancy Obstet. Gynecol., May 1, 2004; 103(5): 1110 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.A. Kelly, B.C. Bond, and L. Poston Aortic adaptation to pregnancy: elevated expression of matrix metalloproteinases-2 and -3 in rat gestation Mol. Hum. Reprod., May 1, 2004; 10(5): 331 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. T. O'Gara, A. J. Greenfield, N. A. Afridi, and S. L. Houser Case 12-2004 - A 38-Year-Old Woman with Acute Onset of Pain in the Chest N. Engl. J. Med., April 15, 2004; 350(16): 1666 - 1674. [Full Text] [PDF]
|
|
|
|
 |
|
 F. F. Immer, A. G. Bansi, A. S. Immer-Bansi, J. McDougall, K. J. Zehr, H. V. Schaff, and T. P. Carrel Aortic dissection in pregnancy: analysis of risk factors and outcome Ann. Thorac. Surg., July 1, 2003; 76(1): 309 - 314. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. J. Weiss and R. B. Smith III Peripheral Vascular Manifestations of Aortic Dissection: Recognition and Management Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1999; 10(2): 27 - 41. [Abstract] [PDF]
|
|
|
|
|
|
C. J.A.M. Zeebregts and M. A. Schepens Reply Ann. Thorac. Surg., May 1, 1998; 65(5): 1512 - 1512. [Full Text] [PDF]
|
|
|
|
|
|
T. O. Cheng Aortic Dissection During Pregnancy Ann. Thorac. Surg., May 1, 1998; 65(5): 1511 - 1512. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
