Acute type A aortic dissection and successful surgical repair in woman at 21 weeks gestational pregnancy with fetal survival

Type A aortic dissection during pregnancy is a rare catastrophe that is associated with high maternal and fetal mortality. Surgical management of the type A aortic aneurysm is imperative to the survival of the mother. The... [ view full abstract ]

Type A aortic dissection during pregnancy is a rare catastrophe that is associated with high maternal and fetal mortality. Surgical management of the type A aortic aneurysm is imperative to the survival of the mother. The gestational age of the fetus at the time of presentation is the major determining factor of weather delivery before initiation of cardiopulmonary bypass is feasible. The management of this patient requires a multidisciplinary approach. We present a case report of a 31 year-old female who was diagnosed with acute type A aortic aneurysm during pregnancy at 21 weeks gestational age. She underwent aortic valve replacement, aortic root replacement and coronary artery bypass graft x 1. Her intraoperative course involved hypothermic circulatory arrest and two rounds of cardiopulmonary bypass. The remainder of her pregnancy was unremarkable and she returned to the hospital for uneventful vaginal delivery of a healthy baby at 39 weeks gestation.