Key result
Cesarean delivery with combined spinal-epidural anesthesia was successfully performed without complications in a pregnant patient with an MYH11 mutation and residual aortic dissection.
Case Report (n=1)
No
Predelivery genetic testing identifying a MYH11 mutation successfully guided the multidisciplinary anesthetic and obstetric management of a high-risk pregnant patient with residual aortic dissection.
Suggests genetic testing may guide management in rare aortopathy pregnancies; leaves open confirmation in prospective studies.
We report a case of a pregnant woman with a history of ascending arch replacement for aortic dissection who still had a residual descending aortic dissection. She underwent urgent genetic testing to identify hereditary aortic-related diseases that might be useful in perinatal management. A mutation in the myosin heavy chain gene (MYH11), indicating a high risk of aortic dissection but a low impact on other vascular systems and organs, was identified. Due to concerns about the development of residual aortic dissection, cesarean delivery with combined spinal-epidural anesthesia was selected. Predelivery genetic testing might be useful for perinatal anesthetic management.
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Kawasaki et al. (2023) conducted a case report in Pregnancy with MYH11 mutation and residual aortic dissection (n=1). Cesarean delivery with combined spinal-epidural anesthesia was evaluated on Maternal and fetal outcomes. Cesarean delivery with combined spinal-epidural anesthesia was successfully performed without complications in a pregnant patient with an MYH11 mutation and residual aortic dissection.
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