Key result
Surgical management of acute Type A aortic dissection during pregnancy requires prompt imaging and complex decision-making regarding concomitant fetal delivery versus in utero aortic repair.
Why the study?
Type A acute aortic dissection during pregnancy is life-threatening for mother and baby, but atypical presentations and concerns over fetal radiation can delay diagnosis and complicate surgical management.
This review summarizes the diagnostic and surgical management challenges of acute type A aortic dissection during pregnancy, emphasizing the need for prompt imaging and careful decision-making regarding fetal delivery.
Requires specialized cardio-obstetric teams for pregnant Type A dissection cases; leaves optimal fetal timing strategies open.
Type A acute aortic dissection (TAAD) during pregnancy is a life-threatening event for both the mother and unborn baby. Pregnancy has been recognised as an independent risk factor for TAAD, postulated to be due to physiological changes that cause hyperdynamic circulation. Presentation can be atypical in many cases and further concern from clinicians of fetal radiation exposure can result in missed or delayed diagnoses. Investigation via quickest form of imaging, whether CT, MRI or transoesophageal echocardiography, should be carried out promptly due to the high risk of mortality. Surgical management of TAAD in pregnancy revolves primarily around the decision to deliver the foetus concomitantly or to perform aortic repair with the foetus in utero. This review will summarise the difficulties faced when managing TAAD in pregnancy, and important questions for future research.
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Rimmer et al. (2020) conducted a review in Type A acute aortic dissection (TAAD) during pregnancy. Surgical management of TAAD was evaluated. Surgical management of acute Type A aortic dissection during pregnancy requires prompt imaging and complex decision-making regarding concomitant fetal delivery versus in utero aortic repair.
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