z-logo
Premium
Pernicious pregnancy: Type B aortic dissection in pregnant women
Author(s) -
Rimmer Lara,
Mellor Sophie,
Harky Amer,
Gouda Mohamed,
Bashir Mohamad
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15354
Subject(s) - medicine , pregnancy , bicuspid aortic valve , aortic dissection , surgery , dissection (medical) , fetus , obstetrics , aortic valve , aorta , genetics , biology
Background Type B aortic dissection (TBAD) occurs seldomly, particularly in pregnancy, but has disastrous consequences for both mother and fetus. The focus of immediate surgical repair of type A aortic dissection due to higher mortality of patients is less clear in its counterpart, TBAD, in which management is controversial and debated. This article collates knowledge so far on this rare event during pregnancy. Methods A comprehensive literature search was performed in PubMed, Scopus, Google Scholar, Embase, and Medline. Key search terms included “type B aortic dissection,” “pregnancy,” and corresponding synonyms. Non‐English papers were excluded. Results Risk factors for TBAD include aortic wall stress due to hypertension, previous cardiac surgery, structural abnormalities (bicuspid aortic valve, aortic coarctation), and connective tissue disorders. In pregnancy, pre‐eclampsia is a cause of increased aortic wall stress. Management of this condition is often conservative, but this is dependent on a number of factors, including gestation, cardiovascular stability of the patient, and symptomology. In most cases, a cesarean section before intervention is carried out unless certain indications are present. Conclusions Due to a scarce number of cases across the decades, it is difficult to determine which management is optimal. The gold‐standard management of TBAD has traditionally been the medical treatment for uncomplicated cases and open surgery for those needing urgent intervention, but with the advent of techniques, such as thoracic endovascular aortic repair, the management of these group of patients continues to develop.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here