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Pregnant aortic dissection

Brandy Shattuck, John Livingstone
We describe the case of a 23-year-old white female, 10-12 weeks pregnant, with a history of intravenous drug use and a recently diagnosed pneumonia, who was found deceased in her bed after a night of sleep. Although postmortem serum toxicology tested positive for alprazolam, tetrahydrocannabinol, and morphine, the ultimate cause of death was determined to be cardiac tamponade secondary to an isolated abscess in the ascending aorta. The patient had several risk factors for aortic rupture and cardiac tamponade including intravenous drug use, pneumonia, and pregnancy...
March 17, 2017: Forensic Science, Medicine, and Pathology
Seisuke Sayama, Norifumi Takeda, Takayuki Iriyama, Ryo Inuzuka, Sonoko Maemura, Daishi Fujita, Haruo Yamauchi, Kan Nawata, Masahiko Bougaki, Hironobu Hyodo, Rieko Shitara, Toshio Nakayama, Atsushi Komatsu, Takeshi Nagamatsu, Yutaka Osuga, Tomoyuki Fujii
OBJECTIVE: To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN: Retrospective case series study. SETTING: Tertiary perinatal care center at a university hospital. POPULATION: Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS that were managed at our institute...
March 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Qian Zhang, Xiaochun Ma, Zhengjun Wang, Chengwei Zou
No abstract text is available yet for this article.
March 12, 2017: International Journal of Gynaecology and Obstetrics
Boglárka Vincze, András Gáspárdy, Levente Kovács, Ervin Albert, Luca Kézér, Ferenc Baska, Ottó Szenci
Transabdominal ultrasonography has been shown to be a useful and reliable method for assessing fetal well-being in horses and cattle. To test the applicability of fetal aortic diameter measurement in cattle, 44 late-term pregnant cows and heifers were examined 21 to 0 days prior to calving. Mean fetal aortic diameter was 2.07 ± 0.14 cm and mean fetal heart rate (FHR) was 109 ± 17 bpm. Three dead calves were dissected and their aortic diameter was measured in a water bath. The mean birth weight (n = 44) was 39...
March 2017: Acta Veterinaria Hungarica
Akshith Rs Shetty, Y P Girish Chandra, S Praveen, Somusekhar Gajula
Forensic pathologists come across many deaths due to natural causes which are sudden. Sudden natural deaths in females who are pregnant warrant thorough investigation and a medico-legal autopsy to rule out any foul play. Here, we report a case of 21-year-old primigravida in her first trimester who suddenly complained of severe chest pain and was brought dead to the hospital with no history suggestive of prior natural disease. At autopsy, the death was attributed to dissection of ascending aorta.
January 1, 2017: Medico-legal Journal
Luis Raul Meza-López, Luis Efren Santos-Martínez, Silvia Hernández-Meneses, Juan Ignacio Moreno-Valencia, Jesus Zaín Campos-Larios, Nielzer Armando Rodríguez-Almendros, Victor Manuel Lozano-Torres, Moisés Cuttiel Calderón-Abbo
No abstract text is available yet for this article.
January 2017: Archivos de Cardiología de México
Jun-Ming Zhu, Wei-Guo Ma, Sven Peterss, Long-Fei Wang, Zhi-Yu Qiao, Bulat A Ziganshin, Jun Zheng, Yong-Min Liu, John A Elefteriades, Li-Zhong Sun
BACKGROUND: Aortic dissection in pregnancy is a rare but lethal catastrophe. Clinical experiences are limited. We report our experience in 25 patients focusing on etiology, management strategies, and outcomes. METHODS: Between June 1998 and February 2015, we treated 25 pregnant women (mean age, 31.6 ± 4.7 years) in whom aortic dissection developed at a mean of 28 ± 10 gestational weeks (GWs). Type A aortic dissection (TAAD) was present in 20 (80%) and type B (TBAD) in 5 (20%)...
November 5, 2016: Annals of Thoracic Surgery
Rafael Kuperstein, Tal Cahan, Rakefet Yoeli-Ullman, Sagit Ben Zekry, Amihay Shinfeld, Michal J Simchen
Patients with Marfan syndrome (MS) face a high risk of aortic dissection during pregnancy. A dilated aortic root (>40 to 45 mm) is considered a relative contraindication for pregnancy. We investigated the risk for aortic dissection and pregnancy outcome in patients with MS. Women with MS who attended our cardiology high-risk pregnancy clinic from 2006 to 2015 were followed clinically and with serial echocardiograms by a multidisciplinary team. Beta blockers were offered and titrated by blood pressure and heart rate...
January 1, 2017: American Journal of Cardiology
Sun Hwa Lee, Seokyong Ryu, Seoung Won Choi, Hye Jin Kim, Tae Kyug Kang, Sung Chan Oh, Suk Jin Cho, Jae Hoon Lee, Euy Suk Chung, Myoung Hwan Kim
BACKGROUND: Aortic dissection in pregnancy is relatively rare, but it is often fatal. The estimated incidence of aortic dissection in the general population is 2.9 per 100,000 person-years. Early recognition and treatment of aortic dissections are crucial for survival. Whereas the majority of patients who present with aortic dissection are older than 50 years of age and have a history of hypertension, younger patients with connective tissue disease, bicuspid aortic valves, or a family history of aortic dissection are also at increased risk for developing this condition...
April 2017: Journal of Emergency Medicine
Xiuhua Dong, Jiakai Lu, Weiping Cheng, Chengbin Wang
Aortic dissection is a rare but devastating disease during pregnancy, usually presenting with sharp pains on the chest or back. We report a pregnant woman suffering from chronic Stanford type A aortic dissection presented with atypical symptoms without pain in the third trimester with markedly dilated aortic root and congestive heart failure, who received concomitant cesarean delivery and aortic repair with good maternal and fetal outcomes. Multidisciplinary approach and tight hemodynamic control are very important...
September 2016: Journal of Clinical Anesthesia
Steven L Lansman, Joshua B Goldberg, Masashi Kai, Gilbert H L Tang, Ramin Malekan, David Spielvogel
Pregnancy engenders changes in hemodynamics and the aortic wall that make a woman more susceptible to aortic dilatation and dissection. This is particularly true of women with aortic dilatation and an aortopathy, including the inherited fibrillinopathies, bicuspid aortic valve, and Turner syndrome. Women in these risk groups may be served best by undergoing elective aortic surgery before becoming pregnant. However, some women present during pregnancy with significant aortic dilatation, rapid expansion, or aortic dissection, and strategies to deal with these situations, while optimizing maternal and fetal outcomes, change as gestation progresses...
June 24, 2016: Journal of Thoracic and Cardiovascular Surgery
Renuka Shanmugalingam, Nina Reza Pour, Siang Chye Chuah, Thi Mong Vo, Roy Beran, Annemarie Hennessy, Angela Makris
BACKGROUND: Arterial dissection is a rare complication of pregnancy and puerperium. There have been reports of aortic, coronary and cervical artery dissection in association with preeclampsia, however, vertebral artery dissection is rarely reported particularly in the antenatal setting in the presence of a Hypertensive Disorder of Pregnancy (HDP).The general annual incidence of symptomatic spontaneous cervicocephalic arterial dissection is 0.0026 % and a data registry reported that 2...
2016: BMC Pregnancy and Childbirth
Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard
No abstract text is available yet for this article.
October 2016: Anaesthesia, Critical Care & Pain Medicine
Alan C Braverman, Marc R Moon, Patrick Geraghty, Marcia Willing, Christopher Bach, Nicholas T Kouchoukos
Loeys-Dietz syndrome due to mutations in TGFBR1 and 2 is associated with early and aggressive aortic aneurysm and branch vessel disease. There are reports of uncomplicated pregnancy in this condition, but there is an increased risk of aortic dissection and uterine rupture. Women with underlying aortic root aneurysm are cautioned about the risk of pregnancy-related aortic dissection. Prophylactic aortic root replacement is recommended in women with aortopathy and aortic root dilatation to lessen the risk of pregnancy...
August 2016: American Journal of Medical Genetics. Part A
Won Ho Kim, Jisue Bae, Seung Won Choi, Jong-Hwan Lee, Chung Su Kim, Hyun Sung Cho, Sangmin M Lee
Aortic dissection during pregnancy is a devastating event for both the pregnant woman and the baby. We report a case of acute aortic dissection (Stanford type A) in a pregnant woman with Marfan syndrome at the 29(th) week of gestation. She underwent a cesarean section followed by an ascending aorta and total arch replacement with cardiopulmonary bypass, without a prior sternotomy. The hemodynamic parameters were kept stable during the cesarean section by using inotropes and vasopressors under transesophageal echocardiography monitoring...
February 2016: Korean Journal of Anesthesiology
Valérie Bernard, Bruno Donadille, Delphine Zenaty, Carine Courtillot, Sylvie Salenave, Aude Brac de la Perrière, Frédérique Albarel, Anne Fèvre, Véronique Kerlan, Thierry Brue, Brigitte Delemer, Françoise Borson-Chazot, Jean-Claude Carel, Philippe Chanson, Juliane Léger, Philippe Touraine, Sophie Christin-Maitre
STUDY QUESTION: What are the prevalence and the outcomes of spontaneous pregnancies (SP) in a large cohort of French women with Turner syndrome (TS)? SUMMARY ANSWER: Amongst 480 women with TS, 27 women (5.6%) had a total of 52 SP, with 30 full-term deliveries for 18 women. WHAT IS KNOWN ALREADY: Primary ovarian insufficiency is a classic feature of TS. So far, few studies have evaluated the rate of SP in these patients. STUDY DESIGN, SIZE, DURATION: The French Ministry of Health set up a National Reference Centre for Rare Growth Disorders (CRMERC), including TS...
April 2016: Human Reproduction
Michael I Brener, Ali R Keramati
No abstract text is available yet for this article.
February 2, 2016: Circulation
Zhenping Chen, Ya Xu, Paul Bujalowski, Andres F Oberhauser, Paul J Boor
Dissecting aortic aneurysm (DAA) is an extended tear in the wall of the aorta along the plane of the vascular media. Our previous studies indicated in a developmental animal model, that DAA was related to pathological alteration in collagen, especially collagen type III. Accordingly, in the present studies, neonatal aortic vascular smooth muscle cells (VSMC) and timed pregnant Sprague-Dawley rat dams were treated with N-(2-aminoethyl) ethanolamine (AEEA), which, as shown previously, causes DAA in offspring...
December 2015: Toxicological Sciences: An Official Journal of the Society of Toxicology
Jeffrey D Crawford, Cindy M Hsieh, Ryan C Schenning, Matthew S Slater, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
We present a case of familial thoracic aortic aneurysm and dissection (FTAAD) in a pregnant female. FTAAD is an inherited, nonsyndromic aortopathy resulting from several genetic mutations critical to aortic wall integrity have been identified. One such mutation is the myosin heavy chain gene (MYH11) which is responsible for 1-2% of all FTAAD cases. This mutation results in aortic medial degeneration, loss of elastin, and reticulin fiber fragmentation predisposing to TAAD. Aortic disease is more aggressive during pregnancy as a result of increased wall stress from hyperdynamic cardiovascular changes and estrogen-induced aortic media degeneration...
January 2016: Annals of Vascular Surgery
Puyu Yang, Jun Zhang, Yanna Li, Hui Wang, Jun Zheng
OBJECTIVE: To evaluate the clinical characteristics of aortic dissection in pregnant patients with Marfan syndrome and the maternal and fetal outcomes in cardiovascular surgery. METHODS: Seven pregnant women with Marfan syndrome with aortic dissection were identified, who were treated in Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2012 and September 2014. Patient charts were reviewed for cardiovascular surgery, occurrence of complications, clinical features and the maternal and fetal outcomes...
May 2015: Zhonghua Fu Chan Ke za Zhi
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