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Pregnant aortic dissection

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https://www.readbyqxmd.com/read/27825688/aortic-dissection-in-pregnancy-management-strategy-and-outcomes
#1
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
https://www.readbyqxmd.com/read/27788933/risk-of-aortic-dissection-in-pregnant-patients-with-the-marfan-syndrome
#2
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...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27743719/acute-type-a-aortic-dissection-in-a-37-week-pregnant-patient-an-unusual-clinical-presentation
#3
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...
October 12, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27555189/an-atypical-presentation-of-chronic-stanford-type-a-aortic-dissection-during-pregnancy
#4
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
https://www.readbyqxmd.com/read/27431443/aortic-symposium-2016-aortic-surgery-in-pregnancy
#5
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
https://www.readbyqxmd.com/read/27422677/vertebral-artery-dissection-in-hypertensive-disorders-of-pregnancy-a-case-series-and-literature-review
#6
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
https://www.readbyqxmd.com/read/27393077/cardiovascular-emergencies-and-cardiac-arrest-in-a-pregnant-woman
#7
Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard
No abstract text is available yet for this article.
July 5, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27125181/pregnancy-after-aortic-root-replacement-in-loeys-dietz-syndrome-high-risk-of-aortic-dissection
#8
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
https://www.readbyqxmd.com/read/26885307/stanford-type-a-aortic-dissection-in-a-patient-with-marfan-syndrome-during-pregnancy-a-case-report
#9
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
https://www.readbyqxmd.com/read/26874361/spontaneous-fertility-and-pregnancy-outcomes-amongst-480-women-with-turner-syndrome
#10
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
https://www.readbyqxmd.com/read/26831438/type-b-dissection-in-a-pregnant-woman-managed-with-peripartum-thoracic-endovascular-aortic-repair
#11
Michael I Brener, Ali R Keramati
No abstract text is available yet for this article.
February 2, 2016: Circulation
https://www.readbyqxmd.com/read/26443843/n-2-aminoethyl-ethanolamine-induced-morphological-biochemical-and-biophysical-alterations-in-vascular-matrix-associated-with-dissecting-aortic-aneurysm
#12
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
https://www.readbyqxmd.com/read/26381327/genetics-pregnancy-and-aortic-degeneration
#13
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
https://www.readbyqxmd.com/read/26311451/-maternal-and-fetal-outcomes-with-aortic-dissection-in-pregnant-patients-with-marfan-syndrome
#14
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
https://www.readbyqxmd.com/read/26132454/pheochromocytoma-in-a-pregnant-woman-with-prior-traumatic-aortic-injury
#15
Ann Kinga Malinowski, Cynthia Maxwell, Mathew Sermer, Barry Rubin, Shital Gandhi, Candice K Silversides
BACKGROUND: Pheochromocytoma, a catecholamine-producing tumor seldom encountered in pregnancy, is often heralded by nonspecific symptoms and undue mortality with delayed diagnosis. The presence of an aortic pseudoaneurysm poses a management challenge given the risk of aortic rupture amplified by hypertensive events. CASE: A 30-year-old woman, gravida 3 para 1, presented at 23 6/7 weeks of gestation with vomiting, chest pain, and severe hypertension. Investigation revealed adrenal pheochromocytoma and pseudoaneurysm at the site of a previous aortic injury...
November 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26117987/-fetal-cardiac-interventions-are-we-ready-for-them
#16
Marzena Dębska, Joanna Szymkiewicz-Dangel, Adam Koleśnik, Piotr Kretowicz, Beata Rebizant, Jacek Witwicki, Romuald Dębski
OBJECTIVE: The aim of the study was to analyze types and methods of intrauterine fetal cardiac interventions performed between June 2011 and December 2013, and to assess the perinatal management of the neonates. METHODS: The program was developed after analysis of the available literature, practical individual training in Linz, Austria, and simulation of the procedure in a dissecting-room. The rules for anesthesia in pregnant women and their fetuses were developed...
April 2015: Ginekologia Polska
https://www.readbyqxmd.com/read/26020727/critical-illness-in-pregnancy-part-ii-common-medical-conditions-complicating-pregnancy-and-puerperium
#17
REVIEW
Kalpalatha K Guntupalli, Dilip R Karnad, Venkata Bandi, Nicole Hall, Michael Belfort
The first of this two-part series on critical illness in pregnancy dealt with obstetric disorders. In Part II, medical conditions that commonly affect pregnant women or worsen during pregnancy are discussed. ARDS occurs more frequently in pregnancy. Strategies commonly used in nonpregnant patients, including permissive hypercapnia, limits for plateau pressure, and prone positioning, may not be acceptable, especially in late pregnancy. Genital tract infections unique to pregnancy include chorioamnionitis, group A streptococcal infection causing toxic shock syndrome, and polymicrobial infection with streptococci, staphylococci, and Clostridium perfringens causing necrotizing vulvitis or fasciitis...
November 2015: Chest
https://www.readbyqxmd.com/read/25964970/triptans-beware-of-vasoconstrictive-effects
#18
(no author information available yet)
Ischaemic disorders, ruptured aneurysm, aortic dissection, gastrointestinal or spinal necrosis. And placental infarction in exposed pregnant women.
October 2014: Prescrire International
https://www.readbyqxmd.com/read/25722251/endovascular-aortic-repair-combined-with-chimney-technique-in-the-treatment-of-stanford-type-b-aortic-dissection-involving-aortic-arch
#19
Hong Liu, Chang Shu, Xin Li, Tun Wang, Ming Li, Quan-Ming Li, Kun Fang, Shalong Wang
BACKGROUND: In this study, we sought to explore the efficacy of endovascular aortic repair combined with the chimney technique in the treatment of Stanford type B aortic dissection involving the aortic arch. METHODS: Between June 2009 and June 2012, 41 consecutive patients were treated with chimney technique at our institute for aortic arch dissection with the primary entry tear adjacent to the orifices of the supra-aortic arteries. The chimney technique was used to reconstruct the left subclavian artery (n = 5) and the left common carotid artery (n = 34)...
2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25689361/anesthesia-considerations-for-cesarean-delivery-in-a-patient-with-loeys-dietz-syndrome
#20
Jessica Cronin, Heidi Bazick Cuschieri, Xiaobo Dong, Gretchen Oswald, Melissa Russo, Hal Dietz, Jamie Murphy
A 28-year-old primigravida female with Loeys-Dietz syndrome presented at 36 weeks' gestation for scheduled primary elective cesarean delivery. The patient had clinical findings consistent with this diagnosis, including mild aortic root dilation, chronic right vertebral artery dissection with 2 intracerebral aneurysms, and small ectasias of the thecal sac in the lumbar region. Pregnant patients with Loeys-Dietz syndrome have significant risks, including aneurysm rupture, new aneurysm formation, and uterine rupture...
February 15, 2015: A & A Case Reports
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