Șulea Cristina M, Kiss Anna B, Ágg Bence, Benke Kálmán, Bartha Elektra, Szilveszter Bálint, Stengl Roland, Csonka Máté, Szabolcs Zoltán, Pólos Miklós
Semmelweis University Heart and Vascular Centre, Budapest, 1122, Hungary.
Hungarian Marfan Foundation, 1122, Budapest, Hungary.
J Cardiothorac Surg. 2025 Jan 29;20(1):105. doi: 10.1186/s13019-025-03357-2.
Aortic dissection occurs rarely during pregnancy but carries a significantly high vital risk for both the mother and the fetus. Early diagnosis and treatment are critical for a successful outcome.
A 32-year-old pregnant woman at 31 weeks of gestation began experiencing shortness of breath, chest pain, and palpitations, which were attributed to an anxiety disorder she had been previously diagnosed with. The symptoms continued to worsen following the delivery when a chest computed tomography investigation revealed signs of chronic type A aortic dissection and an 80 mm post-dissection aneurysm of the ascending aorta. Aortic repair via composite aortic root replacement surgery (Bentall procedure) and partial aortic arch replacement was performed. The patient's postoperative evolution was notable for a series of complications.
Our report highlights the importance of thorough maternal examination during pregnancy. The high mortality rates associated with aortic dissection occurring in pregnant women and the possibility of missed intervention due to atypical clinical presentation warrant the need for standardized international protocols aimed at the prevention and timely diagnosis of prenatal aortic disease.
主动脉夹层在孕期很少发生，但对母亲和胎儿都有极高的生命风险。早期诊断和治疗对取得成功结局至关重要。
一名32岁、孕31周的孕妇开始出现呼吸急促、胸痛和心悸，这些症状被归因于她之前被诊断出的焦虑症。产后症状持续恶化，胸部计算机断层扫描检查显示有慢性A型主动脉夹层的迹象以及升主动脉夹层后80毫米的动脉瘤。通过复合主动脉根部置换手术（Bentall手术）和部分主动脉弓置换进行了主动脉修复。患者术后出现了一系列并发症。
我们的报告强调了孕期对母亲进行全面检查的重要性。与孕妇发生主动脉夹层相关的高死亡率以及因非典型临床表现而可能错过干预的情况，使得有必要制定旨在预防和及时诊断产前主动脉疾病的标准化国际方案。
