Type A aortic dissection in a young 37 weeks pregnant lady successfully treated by Bentall procedure: A case report

Aortic dissection is intimal tear in aorta and collection of blood in between the layers of aortic wall. The incidence of acute type A aortic dissection is between 2.1 and 16.3 per 100,000 persons [1]. Aortic dissection is an infrequent but potentially life threatening complication of pregnancy with most of the cases occurring in third trimester and post-partum period [2]. The most important predisposing factors to aortic dissection are Marfan, Ehlers-Danlos, Turner and Loeys-Dietz syndromes [3]. However, the non sporadic cases can also occur in pregnancy [4].

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Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

The Heart Surgery Forum ◽

10.1532/hsf98.2013246 ◽

2014 ◽

Vol 17 (4) ◽

pp. 196

Author(s):

Erhan Kaya ◽

Halit Yerebakan ◽

Daniel Spielman ◽

Omer Isik ◽

Cevat Yakut

Keyword(s):

Coronary Artery ◽

Aortic Dissection ◽

Right Coronary Artery ◽

Type A ◽

Sudden Onset ◽

Acute Type ◽

Type A Aortic Dissection ◽

Coronary Syndrome ◽

Bentall Procedure ◽

The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

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Acute Type A Aortic Dissection in a 36-Week Pregnant Patient

Case Reports in Emergency Medicine ◽

10.1155/2013/390670 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Erol Kohli ◽

Sharhabeel Jwayyed ◽

Gary Giorgio ◽

Mary Colleen Bhalla

Keyword(s):

Aortic Dissection ◽

Early Recognition ◽

Type A ◽

Pregnant Patient ◽

Acute Type ◽

Third Trimester ◽

Type A Aortic Dissection ◽

Increased Risk ◽

History Of ◽

Aortic Dissections

Aortic dissection is a relatively rare yet often fatal condition. Early recognition and treatment are crucial for survival. While 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, and a family history of aortic dissection are also at an increased risk for developing this condition. A review of the literature revealed a paucity of published cases describing the successful, emergent repair of acute type A aortic dissections in third- trimester gravid patients. We present the case of the successful diagnosis and surgical repair of a 41-year-old female who presented to the emergency department with an acute type A aortic dissection at 36 weeks of gestation.

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Coronary embolism following Bentall procedure and hemiarch resection for acute Type A aortic dissection

Journal of Cardiac Surgery ◽

10.1111/jocs.13820 ◽

2018 ◽

Vol 33 (10) ◽

pp. 682-683

Author(s):

Monica Greci ◽

Marco Russo ◽

Antonio Pellegrino ◽

Carlo Bassano ◽

Paolo Nardi ◽

...

Keyword(s):

Aortic Dissection ◽

Type A ◽

Acute Type ◽

Type A Aortic Dissection ◽

Bentall Procedure ◽

Coronary Embolism

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Successful Repair of Concomitant Acute Type A Aortic Dissection and Saddle Pulmonary Embolism

Aorta ◽

10.1055/s-0038-1639345 ◽

2018 ◽

Vol 06 (01) ◽

pp. 034-036

Author(s):

Fabio Ramponi ◽

Theone Papps ◽

James Edwards

Keyword(s):

Pulmonary Embolism ◽

Aortic Dissection ◽

Type A ◽

Management Plan ◽

Acute Onset ◽

Correct Identification ◽

Acute Type ◽

Pulmonary Embolectomy ◽

Type A Aortic Dissection ◽

Life Threatening

AbstractPatients presenting with acute onset of chest pain require prompt diagnosis and rapid establishment of a management plan. Acute aortic dissection and acute pulmonary embolism are life-threatening emergencies that can mimic each other at presentation. Correct identification of this uncommon scenario is crucial to initiate the appropriate interventions. The authors present a unique case of concomitant acute type A aortic dissection and acute saddle pulmonary embolism; the patient underwent successful aortic repair and pulmonary embolectomy.

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Postoperative Care of Two Patients With End-stage Heart Disease Combined With Type a Aortic Dissection

10.21203/rs.3.rs-404805/v1 ◽

2021 ◽

Author(s):

Xiaofeng Xu ◽

Yunqing Cheng ◽

Juntao Kuang ◽

Xuejun Xie ◽

Jinsong Huang ◽

...

Keyword(s):

Heart Disease ◽

Aortic Dissection ◽

Heart Transplantation ◽

Type A ◽

Acute Type ◽

Donor Heart ◽

Timely Manner ◽

Type A Aortic Dissection ◽

Life Threatening ◽

End Stage

Abstract BackgroundHeart transplantation is a major method in the treatment of end-stage heart disease. Acute type A aortic dissection is a rare and life-threatening disease requiring emergency surgery. Although surgical treatment has achieved certain progress in terms of techniques and equipment in the recent years, the surgical mortality rate is still as high as 25%. It is very rare for patients with end-stage heart disease to simultaneously contract aortic dissection. This study will explore the main points of care after end-stage heart disease combined with aortic dissection.ResultsThe cold ischemic times of the donor heart of the two patients were 340 min and 361 min, and the cardiopulmonary bypass times were 381 min and 411 min. Both were successfully operated and discharged uneventfully. ConclusionsThe combination of heart transplantation with aortic dissection surgery is complicated and is prone to multiple postoperative complications. The nursing staff is required to master the main points of care after heart transplantation and aortic dissection, observe problems in a timely manner, intervene early, and promote the patient’s recovery.

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Outcomes of Preoperative Antiplatelet Therapy in Patients with Acute Type A Aortic Dissection

10.22541/au.162785710.06026705/v1 ◽

2021 ◽

Author(s):

Xuan Jiang ◽

Enyi Shi ◽

Ruixin Fan ◽

Ximing Qian ◽

Hongjia Zhang ◽

...

Keyword(s):

Aortic Dissection ◽

Antiplatelet Therapy ◽

Type A ◽

Coronary Intervention ◽

Acute Type ◽

Type A Aortic Dissection ◽

Coronary Syndrome ◽

Before And After ◽

Life Threatening ◽

Immediate Surgery

Background: Acute type A aortic dissection(ATAAD) is life-threatening and requires immediate surgery. Sudden chest pain may lead to a risk of misdiagnosis as acute coronary syndrome and may lead to subsequent antiplatelet therapy. We used the Chinese Acute Aortic Syndrome Collaboration Database (AAS) to study the effects of antiplatelet therapy (APT) on clinical outcomes. Methods: The AAS database is a retrospective multicentre database where 31 of 3092 had APT with aspirin or clopidogrel or both before surgery. Before and after propensity score matching, the incidence of complications and mortality was compared between APT and non-APT patients by using a logistic regression model. The sample remaining after PSM was 30 in the APT group and 80 in the non-APT group. Results: The sample remaining after matching was 30 in the APT group and 80 in the non-APT group. We found 10 cases with percutaneous coronary intervention in the APT group(33.3%). The APT group received more volume of packed red blood cell (RBC), 8.4±6.05 units; plasma, 401.67±727 ml, and platelet transfusion(14.07±8.92 units). The drainage volume was much more in the APT group( 5009.37±2131.44ml, P=0.004). Mortality was higher in APT group(26% vs 10%, P=0.027). The preoperative APT was independent predictor of mortality(OR 6.808, 95% CI1.554-29.828, P = 0.011). Conclusion: APT prior to ATAAD repair was associated with more transfusions and higher early mortality. The timing of surgery should be carefully considered based on the patient’s status and the surgeon’s experience.

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