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J Card Surg ; 37(6): 1705-1711, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35352396

RESUMO

INTRODUCTION: Acute-type aortic dissection (AD) during pregnancy is considered a rare and potentially fatal complication for both mother and fetus. Although the definite treatment for an acute-type AD is considered to be open-heart surgery, the decision to perform such a surgery during pregnancy requires a multidisciplinary approach and carries significant risks. METHODS: In the present review of the literature, we have discussed various challenges in the management of acute-type AD during pregnancy, including therapeutic approaches, choosing the preferred imaging modalities, surgical techniques, and medication challenges. We have also reported an 8-week pregnant woman with Marfan syndrome who presented with chest pain and was diagnosed with acute AD. RESULTS: The patient underwent a Bentall operation and was discharged in good condition with her fetus alive. The medical team's various decisions during preoperative, operative, and postoperative treatments were discussed. CONCLUSIONS: Type A AD is considered infrequent in the second and third trimester of pregnancy and rare in the first trimester. Performing a CMR study without contrast in stable patients can help evaluate the extension of the flap. Urgent surgery in the hands of a skilled surgeon may prove lifesaving for the mother while maximizing the likelihood of preserving the fetus.


Assuntos
Aneurisma Aórtico , Dissecção Aórtica , Síndrome de Marfan , Complicações Cardiovasculares na Gravidez , Dissecção Aórtica/diagnóstico , Aneurisma Aórtico/cirurgia , Feminino , Humanos , Síndrome de Marfan/complicações , Síndrome de Marfan/diagnóstico , Síndrome de Marfan/cirurgia , Gravidez , Complicações Cardiovasculares na Gravidez/cirurgia , Primeiro Trimestre da Gravidez
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