Aortic dissection in pregnant woman with the Marfan syndrome
Uchida, T.; Ogino, H.; Ando, M.; Okita, Y.; Yagihara, T.; Kitamura, S.
Kyobu Geka. Japanese Journal of Thoracic Surgery 55(8 Suppl): 693-696
2002
ISSN/ISBN: 0021-5252 PMID: 12174660 Document Number: 6196
In patients with Marfan syndrome, pregnancy is associated with a potential higher risk of aortic dissection. To determine the incidence and characteristics of aortic dissection in pregnancy, clinical courses of 8 patients with Marfan syndrome were reviewed. Aortic dissection occurred in 3 patients, one of whom had developed rapid dilatation of the ascending aorta during pregnancy. The patient underwent Bentall operation subsequent to cesarean section and simple hysterectomy. All patients tolerated pregnancy well, with favorable maternal and fetal outcomes. Follow-up echocardiography showed no apparent worsening of cardiovascular status attributable to pregnancy such as aortic dilatation and aortic regurgitation except for one patient. Dilatation of the ascending aorta during pregnancy is considered to be an important predictor for aortic dissection. Close observation should be mandatory in such patients. In patients with serious cardiovascular involvement such as acute aortic dissection, cesarean section is preferable for delivery. To prevent hemorrhagic complications under systemic heparinization, simultaneous hysterectomy should be considered as one option.
Document emailed within 1 workday
