Combined Cesarean Delivery and Repair of Acute Ascending and Aortic Arch Dissection at 32 Weeks of Pregnancy

Abstract

n a r AHEALTHY 35-YEAR-OLD gravida 2 para 1 woman at 32 3 weeks’ gestational age was admitted to an outside ospital for an acute onset of chest pain that began that day at er baby shower. Owing to an episode of transient hypoxemia, he was worked up for pulmonary embolism. Computed tomoraphic examination was negative for pulmonary embolism but id show a Stanford type-A dissection. Before this admission, he pregnancy was uneventful and included a normal transthoacic echocardiogram (echocardiography was performed owing o a history suggestive of connective tissue disease). The paient was transferred to the authors’ institution, where an emerency cesarean section was performed, and a healthy male nfant was delivered. The infant’s birth was followed by immediate aortic repair nd aortic valve resuspension. Postoperatively, the patient and er newborn infant underwent genetic testing that was diagostic for Marfan syndrome. This case report discusses the anagement of aortic dissection in pregnancy and Marfan yndrome.