scholarly journals Aortic Dissection During Pregnancy and Postpartum

2020 ◽  
Author(s):  
Xiangli Meng ◽  
Jijing Han ◽  
Li Wang ◽  
Qingqing Wu
Keyword(s):  
Aortic Dissection ◽  
Postpartum Period ◽  
Mode Of Delivery ◽  
Type A ◽  
Fetal Mortality ◽  
Type B ◽  
Total Study Population ◽  
Type A Aortic Dissection ◽  
Pregnancy And Postpartum ◽  
Stanford Type B

Patients with aortic dissection during pregnancy and postpartum period exhibit high mortality. At present, a complete overview of aortic dissection during pregnancy and postpartum period is lacking. This systematic review includes 80 reports published from 2000-2020, comprising a total study population of 103 patients with aortic dissection. It was suggested that Stanford Type A aortic dissection is more likely to occur in the third trimester, while Stanford Type B is more likely to occur within 12 weeks postpartum. The most common risk factor was connective tissue disease, with no other known risk factors. Mode of delivery has no significant effect on the type of postpartum aortic dissection. Reduced maternal and fetal mortality was observed when patients with Stanford Type A aortic dissection occurring after 28 gestational weeks underwent aortic replacement after cesarean section. Patients with Stanford Type B aortic dissection were treated mainly with medication and/or endovascular repair. Contemporary management of patients during pregnancy and within 12 weeks postpartum requires multidisciplinary cooperation and includes serial, non-invasive imaging, biomarker testing, and genetic risk profiling for aortopathy. Early diagnosis and accurate treatment are essential to reduce maternal and fetal mortality.

scholarly journals Giant cell aortitis leading to Stanford type B and type A aortic dissection

JRSM Open ◽  
2017 ◽  
Vol 8 (10) ◽  
pp. 205427041771556
Author(s):  
Ahmed El-Medany ◽  
W Wallace ◽  
E Mcrorie ◽  
Sy Tan ◽  
K Lim
Keyword(s):  
Aortic Dissection ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Type A ◽  
Type B ◽  
Type A Aortic Dissection ◽  
Stanford Type B

Lesson This report provides a rare histological example and the appropriate management of spontaneous aortic dissection secondary to giant cell arteritis.

scholarly journals Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair for Type B Dissection

2020 ◽  
Vol 23 (4) ◽  
pp. E524-E526
Author(s):  
Masato Hayakawa ◽  
Takaaki Nagano ◽  
Isao Nishijima ◽  
Kento Shinzato ◽  
Ryo Ikemura ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Type A ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Entry Site ◽  
Type A Aortic Dissection ◽  
Aortic Repair ◽  
Type B Dissection

Background: A 64-year-old woman presented with dilatation of the distal aortic arch secondary to chronic type B aortic dissection. Case Report: The patient underwent fenestrated thoracic endovascular aortic repair (TEVAR) for closure of the entry site, and reconstruction of the left subclavian artery with a covered stent. On the 40th postoperative day, a retrograde type A aortic dissection (RTAD) was observed on computed tomography and she underwent emergency surgery. The entry tear, related to the proximal bare metal stent, was located in front of the aortic arch. A partial aortic arch replacement was performed. Conclusion: Consideration of the risk factors of RTAD is important when performing TEVAR.

Hybrid Thoracic Stent Graft Repair of a Complex Type B Aortic Dissection in a Patient who Presented Three Weeks after Repair of a Type a Aortic Dissection

2008 ◽  
Vol 3 (3) ◽  
pp. 158-160
Author(s):  
Puja Gaur ◽  
Karthikeshwar Kasirajan ◽  
Daniel L. Miller ◽  
Thomas A. Vassiliades
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Hybrid Approach ◽  
False Lumen ◽  
Type A ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type A Aortic Dissection ◽  
Stent Graft Repair ◽  
Thoracic Stent Graft

Long-term management after repair of a type A aortic dissection includes aggressive medical therapy and routine surveillance with serial imaging to ensure thrombosis of the false lumen. Retained patency of the false lumen can lead to either the development of a false lumen aneurysm with a subsequent rupture or extension of dissection. Typically such events occur late, usually months after repair, and are treated with either a conventional one-stage open thoracoabdominal repair or a two-stage “elephant trunk” procedure. However, most patients who undergo such procedures experience major complications and the procedure-related mortality rate is high. We present a unique case of a 61-year-old woman who presented with a ruptured type B aortic dissection 3 weeks after repair of a type A aortic dissection. She underwent an emergent thoracotomy and primary repair of the ruptured aorta followed by concomitant arch debranching and thoracic stent graft placement. Simultaneous surgical debranching with a median sternotomy and endovascular repair with stent grafts is an attractive hybrid approach in patients who present with an acute rupture of a false lumen aneurysm soon after initial repair of an aortic dissection, a situation in which a conventional repair is not feasible. This report emphasizes that hybrid thoracic stent graft repair should be considered for such high-risk patients in the near future as it offers them relatively lower morbidity and mortality compared with what is seen with conventional repairs.

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