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Published in: Irish Journal of Medical Science (1971 -) 3/2016

01-08-2016 | Brief Report

A successful cesarean section followed with endovascular stent-graft implantation for a 36-week twin pregnancy with acute aortic dissection: a case report

Authors: Qun Hao, Hao Wang, Cheng Zhang, Ai-qing Ma, Yuan-zhe Wu

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2016

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Abstract

Introduction

It is a first case report for a woman pregnant with twins who suddenly ruptured with a Stanford type B aortic dissection.

Materials and methods

A 24-year-old pregnant patient gravida 1 and para 0 at the 36th gestation week was sent to our Emergency Department under the medical monitoring by the local gynecologist. Her primary complaints were that she suddenly felt “severe tearing chest pain”. Ultrasound image illustrated fetal twins at cephalic positions about 36th gestation week. An emergent magnetic resonance angiography (MRA) of aorta is given below: dissection of the descending aorta arisen from the descending aorta to the bifurcation of abdominal aorta suggestive of Stanford type B aortic dissection.

Results

The two babies were delivered by an emergent cesarean section and stent-graft placement of the descending thoracic aorta was performed on the mother thereafter.

Conclusion

This case report illustrates the value of comprehensive multidisciplinary discussion and collaboration among different departments to make quick decisions. Endovascular stent-graft repair may be the best option for the treatment of Stanford type B aortic dissection in late pregnancy.
Literature
1.
go back to reference Scott C, Burruss N, Kalimi R, Manetta F, Palazzo RS, Graver LM (2001) Acute ascending aortic dissection during pregnancy. Am J Crit Care 10:430–433PubMed Scott C, Burruss N, Kalimi R, Manetta F, Palazzo RS, Graver LM (2001) Acute ascending aortic dissection during pregnancy. Am J Crit Care 10:430–433PubMed
2.
go back to reference O’Gara PT, Greenfield AJ, Afridi NA, Houser SL (2004) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12–2004. A 38-year-old woman with acute onset of pain in the chest. N Engl J Med 350:1666–1674CrossRefPubMed O’Gara PT, Greenfield AJ, Afridi NA, Houser SL (2004) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12–2004. A 38-year-old woman with acute onset of pain in the chest. N Engl J Med 350:1666–1674CrossRefPubMed
3.
go back to reference Vanden Hoek T, Morrison LJ (2010) Part 12: cardiac arrest in special situations. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Circulation 2010(122):S829–S861CrossRef Vanden Hoek T, Morrison LJ (2010) Part 12: cardiac arrest in special situations. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Circulation 2010(122):S829–S861CrossRef
4.
go back to reference Roberts WE (1981) Aortic dissection: anatomy, consequences and causes. Am Heart 101:195–214CrossRef Roberts WE (1981) Aortic dissection: anatomy, consequences and causes. Am Heart 101:195–214CrossRef
5.
go back to reference Thalmann M, Sodeck GH, Domanovits H, Grassberger M, Loewe C, Grimm M et al (2011) Acute type A aortic dissection and pregnancy: a population-based study. Eur J Cardiothorac Surg 39(6):e159–e163CrossRefPubMed Thalmann M, Sodeck GH, Domanovits H, Grassberger M, Loewe C, Grimm M et al (2011) Acute type A aortic dissection and pregnancy: a population-based study. Eur J Cardiothorac Surg 39(6):e159–e163CrossRefPubMed
6.
go back to reference Wilson SK, Hutchins GM (1982) Aortic dissecting aneurysms: causative factors in 204 subjects. Arch Pathol Lab Med 106:175–180PubMed Wilson SK, Hutchins GM (1982) Aortic dissecting aneurysms: causative factors in 204 subjects. Arch Pathol Lab Med 106:175–180PubMed
7.
go back to reference Savi C, Villa L, Civardi L, Condemi AM (2007) Two consecutive cases of type A aortic dissection after delivery. Minerva Anestesiol 73:381–38 Savi C, Villa L, Civardi L, Condemi AM (2007) Two consecutive cases of type A aortic dissection after delivery. Minerva Anestesiol 73:381–38
8.
go back to reference Grubb KJ, Kron IL (2011) Sex and gender in thoracic aortic aneurysms and dissection. Semin Thorac Cardiovasc Surg 23(2):124–125CrossRefPubMed Grubb KJ, Kron IL (2011) Sex and gender in thoracic aortic aneurysms and dissection. Semin Thorac Cardiovasc Surg 23(2):124–125CrossRefPubMed
9.
go back to reference Shiga T, Wajima Z, Apfel CC, Inoue T, Ohe Y (2006) Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis. Arch Intern Med 166(13):1350–1356CrossRefPubMed Shiga T, Wajima Z, Apfel CC, Inoue T, Ohe Y (2006) Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis. Arch Intern Med 166(13):1350–1356CrossRefPubMed
11.
go back to reference Xu SD, Huang FJ, Du JH, Li Y, Fan ZM, Yang JF et al (2008) A study of aortic dimension in type B aortic dissection. Interact CardioVasc Thorac Surg 7:244–248CrossRefPubMed Xu SD, Huang FJ, Du JH, Li Y, Fan ZM, Yang JF et al (2008) A study of aortic dimension in type B aortic dissection. Interact CardioVasc Thorac Surg 7:244–248CrossRefPubMed
12.
go back to reference Parker JD, Golledge J (2008) Outcome of endovascular treatment of acute type B aortic dissection. Ann Thorac Surg 86:1707–1712CrossRefPubMed Parker JD, Golledge J (2008) Outcome of endovascular treatment of acute type B aortic dissection. Ann Thorac Surg 86:1707–1712CrossRefPubMed
13.
go back to reference Steuer J, Eriksson MO, Nyman R et al (2011) Early and long-term outcome after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection. Eur J Vasc Endovasc Surg 41:318.21–323.21CrossRef Steuer J, Eriksson MO, Nyman R et al (2011) Early and long-term outcome after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection. Eur J Vasc Endovasc Surg 41:318.21–323.21CrossRef
14.
go back to reference Rosenberger Laura H, Adams Joshua D, Kern John A et al (2012 ) Complicated postpartum type B aortic dissection and endovascular repair. Obstet Gynecol 119(2 Pt 2):480–483CrossRefPubMedPubMedCentral Rosenberger Laura H, Adams Joshua D, Kern John A et al (2012 ) Complicated postpartum type B aortic dissection and endovascular repair. Obstet Gynecol 119(2 Pt 2):480–483CrossRefPubMedPubMedCentral
15.
go back to reference Schlechta Bernhard, Wiedemann Dominik, Eppel Wolfgang et al (2012) Uncomplicated vaginal delivery 6 years after stent graft repair of an acute traumatic aortic transection. Interact Cardiovasc Thorac Surg 14:120–121CrossRefPubMed Schlechta Bernhard, Wiedemann Dominik, Eppel Wolfgang et al (2012) Uncomplicated vaginal delivery 6 years after stent graft repair of an acute traumatic aortic transection. Interact Cardiovasc Thorac Surg 14:120–121CrossRefPubMed
16.
go back to reference Hao Zhang, Zhi-Wei Wang, Zhen Zhou et al (2012) Endovascular stent-graft placement or open surgery for the treatment of acute type B aortic dissection: a meta-analysis. Ann Vasc Surg 26:454–461CrossRef Hao Zhang, Zhi-Wei Wang, Zhen Zhou et al (2012) Endovascular stent-graft placement or open surgery for the treatment of acute type B aortic dissection: a meta-analysis. Ann Vasc Surg 26:454–461CrossRef
Metadata
Title
A successful cesarean section followed with endovascular stent-graft implantation for a 36-week twin pregnancy with acute aortic dissection: a case report
Authors
Qun Hao
Hao Wang
Cheng Zhang
Ai-qing Ma
Yuan-zhe Wu
Publication date
01-08-2016
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 3/2016
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-015-1260-2

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