Key result
Emergency Caesarean section followed by a Bentall type operation was successfully performed on a 31-year-old pregnant woman with Marfan's syndrome and acute aortic dissection, resulting in good outcomes for both mother and neonate.
Case Report (n=1)
No
A one-stage emergency Caesarean section followed by a Bentall procedure can be successfully performed in a pregnant patient with Marfan syndrome and acute aortic dissection at 40 weeks gestation.
Answers are grounded in this paper and cite their sources.
May support combined cesarean-Bentall in select late-pregnancy Marfan patients with dissection; hypothesis-generating and should not yet change practice.
症例は26歳，女性．妊娠40週目で妊娠経過はとくに問題なかったが，突然胸背部痛が出現し，当院に搬送された．高身長，クモ状指，胸椎側弯を認め， Marfan 症候群と診断された．また，心エコーで AR III 度，心嚢液貯留，大動脈基部の拡張および上行大動脈に flap を認めたため，急性大動脈解離を疑い，本人および家人の了承を得て造影 CT を施行したところ，大動脈弁輪拡張症 （AAE） と，基部から上行大動脈にかけての解離 （Stanford A），および遠位弓部から腹部にかけての解離 （Stanford B） を認めた．この症例に対し，同日，帝王切開術にひき続き， Bentall 型手術を施行した．術中ヘパリン使用による子宮出血が懸念されたがとくに問題にはならず，母子ともに良好な結果を得た．
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Ryugo et al. (2008) conducted a case report in Marfan's syndrome with acute aortic dissection during pregnancy (n=1). Emergency Caesarean section followed by Bentall type operation was evaluated on Survival and clinical outcome of mother and neonate. Emergency Caesarean section followed by a Bentall type operation was successfully performed on a 31-year-old pregnant woman with Marfan's syndrome and acute aortic dissection, resulting in good outcomes for both mother and neonate.
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