title: [Peripartum aortic dissection].
abstract: A 29-year-old primagravida developed severe chest pains during labor. An emergency caesarean section was performed as the symptoms persisted. Imaging diagnosis immediately after delivery revealed an acute proximal (type A) aortic dissection. The patient was transferred to the nearest cardiothoracic surgery centre and successful emergency surgical aortic repair was performed. The perioperative course of a type A aortic dissection during pregnancy and labor is complicated by time pressure, diagnostic restrictions until delivery and potentially fatal uterine bleeding during cardiopulmonary bypass and hypothermic cardiac arrest. This case report describes the diagnosis and the surgical, anesthesiological and gynecological management of this life-threatening peripartum complication.
authors.affiliation: Klinische Abteilung für Anästhesie, für Herz- und Gefäßchirurgie und Intensivmedizin, Universitätsklinik für Anästhesie und Intensivmedizin Graz, Auenbruggerplatz 29/I, 8036, Graz, Österreich. christoph.pachler@medunigraz.at
authors.forename: C
authors.initials: C
authors.lastname: Pachler
authors.forename: I
authors.initials: I
authors.lastname: Knez
authors.forename: E
authors.initials: E
authors.lastname: Petru
authors.forename: O
authors.initials: O
authors.lastname: Dörfler
authors.forename: M
authors.initials: M
authors.lastname: Vicenzi
authors.forename: W
authors.initials: W
authors.lastname: Toller
mesh_terms: D000328:Adult; D000758:Anesthesia; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002585:Cesarean Section; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed