Why the study?
Does a two-stage surgical strategy (Caesarean section followed by aortic repair) improve outcomes in a pregnant patient with Marfan's syndrome and acute type A aortic dissection?
Case Report (n=1)
No
Does a two-stage surgical strategy (Caesarean section followed by aortic repair) improve outcomes in a pregnant patient with Marfan's syndrome and acute type A aortic dissection?
Answers are grounded in this paper and cite their sources.
A two-stage strategy of emergency Caesarean section followed by aortic repair half a day later was successful for a pregnant patient with Marfan's syndrome and acute type A aortic dissection.
妊娠後期に急性A型大動脈解離を発症し，母子ともに救命できたMarfan症候群の1例を報告する．症例は34歳女性で，家族歴はないが典型的なMarfan症候群の身体的特徴を呈し，3回の満期経腟分娩歴があった．4回目の妊娠38週時に突然の胸背部痛が出現し，Stanford A型急性大動脈解離と診断された．心嚢液の貯留はなく血行動態も安定しており，ヘパリン投与による胎盤剥離面からの子宮出血が危惧されることから，まず全身麻酔下に帝王切開で胎児を娩出しその後約半日間，鎮静と人工呼吸器管理を続け，後出血がないことを確認し，自己弁温存大動脈基部置換術を施行した．母子ともに特に合併症なく，良好な結果を得た．
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Yamabi et al. (2019) conducted a case report in Acute type A aortic dissection in Marfan's syndrome during pregnancy (n=1). Emergency Caesarean section followed by aortic valve reimplantation and replacement of the ascending aorta was evaluated on Maternal and neonatal survival and discharge.
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