Key result
Frozen elephant trunk arch repair for type A dissection in situs inversus achieves 10-year maternal survival.
Why the study?
Acute type A aortic dissection during pregnancy with situs inversus totalis is exceptionally rare and presents unique surgical challenges requiring individualized operative planning.
Case Report (n=1)
Complex arch repair with frozen elephant trunk is anatomically feasible for acute type A aortic dissection in pregnant patients with situs inversus totalis, successfully prioritizing maternal rescue though carrying high risk for fetal demise.
OBJECTIVE: Acute type A aortic dissection during pregnancy with situs inversus totalis is exceptionally rare. METHODS: We report a 27-year-old woman at 24 weeks of gestation who underwent emergency ascending aortic and total arch replacement with frozen elephant trunk implantation. RESULTS: Fetal demise occurred on postoperative day 1, but the mother recovered without neurological deficit and remained well at 10-year follow-up. CONCLUSIONS: This case demonstrates the feasibility of complex arch repair in mirror-image anatomy and highlights the importance of individualized operative planning and multidisciplinary maternal-fetal management in experienced aortic centres.
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Yang et al. (2026) conducted a case report in Acute type A aortic dissection in pregnancy with situs inversus totalis (n=1). Ascending aortic and total arch replacement with frozen elephant trunk implantation was evaluated on Maternal and fetal survival. Complex arch repair with frozen elephant trunk in a pregnant woman with type A aortic dissection and situs inversus totalis achieved maternal survival at 10 years, despite early fetal demise.
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