Emergency Cesarean section followed by aortic root and ascending aorta replacement can be successfully performed in pregnant patients with Marfan syndrome presenting with acute type A aortic dissection.
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Supports feasibility of combined cesarean-aortic surgery in pregnant Marfan patients with type A dissection; hypothesis-generating and requires confirmation before practice change.
A 25-year-old woman with Marfan syndrome in the 37th week of pregnancy was referred for acute chest pain and dyspnea. An emergency Cesarean section was performed because of fetal distress. Intraoperative echocardiography at the end of the Cesarean section showed dilatation of the aortic root and dissection of the ascending aorta. The patient underwent replacement of the aortic root and the ascending aorta on the following day because of uterine bleeding. The postoperative course was uneventful for the mother and her baby.
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Akashi et al. (2000) studied this question.
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