Key result
Valve-sparing aortic root replacement enables pregnancy prolongation to 38 weeks in a Marfan syndrome case.
Case Report (n=1)
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Valve-sparing aortic root replacement (David procedure) can be successfully performed during the second trimester of pregnancy in patients with Marfan syndrome and severe aortic pathology, allowing for safe prolongation of pregnancy and live birth.
The article presents a clinical case of valve sparing aortic root replacement (David Procedure) in 36 year - old woman with the Marfan syndrome at the 27th week of gestation followed by successful prolongation of pregnancy. Indications for reconstructive intervention with cardiopulmonary bypass were: severe aortic valve insufficiency, Sinus of Valsalva Aneurysm (66 mm) and the ascending aorta dilatation (53 mm) with a rapid increase of aortic root dimension (12 mm during 9 weeks). The patient underwent a valve sparing aortic root replacement according to David procedure using Gelweave Valsalva graft (Vascutec) No 28 The time of cardiopulmonary bypass was 137 minutes; the time of aortic cross-clamping was 107 minutes. The patient was discharged from the hospital in a satisfactory condition in 21 days after the operation. Pregnancy was prolonged and ended with a planned cesarean section at 38 weeks of gestation, the birth of a boy with an Apgar score of 7/8.
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Базылев et al. (2018) conducted a case report in Marfan syndrome with severe aortic valve insufficiency and aortic root dilatation during pregnancy (n=1). Valve sparing aortic root replacement (David Procedure) was evaluated on Prolongation of pregnancy and maternal/fetal survival. Valve-sparing aortic root replacement (David Procedure) was successfully performed in a 36-year-old pregnant woman with Marfan syndrome at 27 weeks gestation, allowing prolongation of pregnancy to 38 weeks.
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