Key result
Third-trimester Type B aortic dissection in Marfan syndrome despite normal initial evaluation underscores whole aorta imaging.
Why the study?
Physiologic hemodynamic changes in the third trimester and postpartum make pregnant women with Marfan syndrome more vulnerable to complications of aortic disease.
Highlights that pregnant women with Marfan syndrome can develop distal Type B aortic dissections even with normal aortic root dimensions, suggesting a potential need for whole aorta imaging during pregnancy.
Alerts to monitor entire aorta in pregnant Marfan patients despite normal root; case report leaves open need for routine whole-aorta screening.
The physiologic changes of pregnancy make pregnant women with Marfan syndrome (MFS) more vulnerable to complications of aortic disease. Significant hemodynamic changes in the third trimester and postpartum may explain the increased susceptibility to aortic complications during this time frame. The rate of cardiovascular complications in MFS is 2%–6%. We presented a case of Type B aortic dissection in a pregnant patient with MFS in the third trimester and normal evaluation at the initial prenatal assessment. This case report highlights the importance of comprehensive evaluation during pregnancy and the consideration of whole aorta imaging in addition to the routine transthoracic echocardiographic assessment of the aortic root.
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Zarudskaya et al. (2026) studied this question. A pregnant Marfan syndrome patient developed Stanford Type B aortic dissection in the third trimester despite normal initial evaluation, highlighting need for whole aorta imaging.
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