Key result
A sequential surgical approach comprising emergency cesarean section, prophylactic uterine artery embolization, and delayed cardiac surgery resulted in successful maternal and neonatal survival in a 38-week pregnant patient with acute type A aortic dissection.
Why the study?
Stanford Type A aortic dissection complicating pregnancy is exceedingly rare and catastrophic, requiring management that balances maternal hemodynamic stability and fetal viability.
Does a sequential surgical approach with multidisciplinary collaboration improve outcomes in a pregnant patient with acute type A aortic dissection?
Case Report (n=1)
No
Does a sequential surgical approach with multidisciplinary collaboration improve outcomes in a pregnant patient with acute type A aortic dissection?
A sequential multidisciplinary surgical approach including cesarean section, uterine artery embolization, and Bentall procedure with CABG can successfully manage acute type A aortic dissection in late pregnancy.
Stanford Type A aortic dissection (TAAD) complicating pregnancy is exceedingly rare yet catastrophic, representing a leading cause of maternal cardiovascular mortality. Management requires balancing maternal hemodynamic stability and fetal viability. A 31-year-old woman (G2P0) at 38 weeks gestation presented with acute tearing chest pain. Computed tomography angiography confirmed TAAD extending from ascending aorta to proximal arch, and the right coronary artery was affected. Transthoracic echocardiography confirmed TAAD with aortic sinus dilation (40 mm) and moderate aortic regurgitation. Multidisciplinary management included emergency cesarean section delivering a healthy female infant (Apgar 9/9/10), followed by prophylactic uterine artery embolization to mitigate hemorrhage risk during subsequent cardiac surgery. The patient underwent Bentall procedure combined with coronary artery bypass grafting. The patient recovered uneventfully, discharged on postoperative day 14. Two-month follow-up demonstrated adequate aortic remodeling with regional residual distal dissection. This case demonstrates that a sequential surgical approach with multidisciplinary collaboration can optimize outcomes in late pregnancy complicated by TAAD.
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Luyang et al. (2026) conducted a case report in Acute Type A aortic dissection in late pregnancy (n=1). Sequential surgical approach (cesarean section, uterine artery embolization, Bentall procedure with CABG) was evaluated on Maternal and neonatal survival and recovery. A sequential surgical approach comprising emergency cesarean section, prophylactic uterine artery embolization, and delayed cardiac surgery resulted in successful maternal and neonatal survival in a 38-week pregnant patient with acute type A aortic dissection.
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