Key result
In two pregnant women with acute aortic dissection, performing a cesarean section followed immediately by a Bentall procedure resulted in the survival and good recovery of both mothers and their children.
Why the study?
Does the Bentall procedure concomitant with cesarean section improve survival in pregnant women with acute aortic type A dissection?
Case Report (n=2)
No
Does the Bentall procedure concomitant with cesarean section improve survival in pregnant women with acute aortic type A dissection?
In pregnant women with acute type A aortic dissection, immediate cesarean section followed by the Bentall procedure without deep hypothermic circulatory arrest can be a safe and effective life-saving strategy for both mother and child.
Answers are grounded in this paper and cite their sources.
May support combined cesarean-Bentall as option in pregnant type A dissection; hypothesis-generating, requires prospective validation.
Acute aortic type A dissection is a life-threatening disease that requires immediate surgical intervention. When dissection occurs during pregnancy, it is of high risk for both the mother and the fetus. In this study, we reported two cases of acute aortic dissection in late pregnancy at 28 weeks and 32 weeks of gestation respectively. After the two patients underwent a cesarean section and delivered a baby, we performed composite graft replacement of the aortic valve, aortic root and ascending aorta, with re-implantation of the coronary arteries into the graft (Bentall procedure) instead of repairing the arch with deep hypothermia and circulation arrest. Both mothers and children survived and recovered well.
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Guo et al. (2011) conducted a case report in Acute aortic dissection in pregnancy (n=2). Bentall procedure concomitant with cesarean section was evaluated on Maternal and fetal survival. In two pregnant women with acute aortic dissection, performing a cesarean section followed immediately by a Bentall procedure resulted in the survival and good recovery of both mothers and their children.
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