title: Surgical treatment and thoracic endovascular aortic repair in type A aortic dissection in a pregnant patient with Marfan syndrome.
abstract: We report an acute aortic dissection type Stanford A extending down to both iliac arteries affecting a 32-year-old woman suspected to have Marfan syndrome during week 37 of pregnancy. In a multidisciplinary approach, and emergency Cesarean section was performed followed by an abdominal hysterectomy and a valve-sparing aortic root replacement using a reimplantation technique. The aorta was replaced up to the hemi arch. Because of the high suspicion of visceral ischemia as confirmed ex juvantibus, an endovascular stent graft was implanted. Molecular testing revealed a frameshift mutation and confirmed the diagnosis of Marfan syndrome. Both the patient and her healthy child underwent an uneventful recovery.
authors.affiliation: Department of Cardiac Surgery, University Clinic Bonn, Bonn, Germany. Electronic address: doerthe.sterner@ukb.uni-bonn.de.
authors.forename: Doerthe
authors.initials: D
authors.lastname: Sterner
authors.affiliation: Department of Cardiac Surgery, University Clinic Bonn, Bonn, Germany.
authors.forename: Chris
authors.initials: C
authors.lastname: Probst
authors.affiliation: Department of Cardiac Surgery, University Clinic Bonn, Bonn, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Mellert
authors.affiliation: Department of Cardiac Surgery, University Clinic Bonn, Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schiller
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002585:Cesarean Section; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008382:Marfan Syndrome / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed