5 years ago

Peripartum type B aortic dissection in patients with Marfan syndrome who underwent aortic root replacement: a case series study

T Nakayama, N Takeda, R Inuzuka, T Iriyama, S Sayama, M Bougaki, A Komatsu, Y Osuga, H Hyodo, T Nagamatsu, H Yamauchi, S Maemura, T Fujii, R Shitara, K Nawata, D Fujita
Objective To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). Design Retrospective case series study. Setting Tertiary perinatal care centre at a university hospital. Population Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute. Methods The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records. Main outcome measures Obstetrical management and complication including the incidence of AD throughout the peripartum period. Results Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test). Conclusions Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm. Tweetable abstract MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/1471-0528.14635

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.