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An Aortopathy Dilemma in Pregnancy: A Rare Case Report Publisher



Saeidi M1 ; Movahedi M2 ; Bahrami P3 ; Shokraniforoushani R4 ; Sheikhbahaei E5
Authors
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Authors Affiliations
  1. 1. Chamran Heart Center AND Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Obstetrics and Gynecology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Cardiology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. School of Medicine, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Source: ARYA Atherosclerosis Published:2021


Abstract

BACKGROUND: The most dramatic diseases in the aorta are aortic dissection and aneurysm, which both of them are common in pregnant women with Marfan syndrome (MFS). According to recommendations in existing guidelines, pregnancy is not recommended in patients with severe dilation of the aorta and patients with MFS with aortic dilation > 45 mm should have prophylactic aortic repair before pregnancy. CASE REPORT: In this rare and unique report, we described a 34-year-old pregnant woman with marfanoid feature who had an approximate aortic root of 60 mm and severe aortic insufficiency. She denied terminating the pregnancy at her first prenatal visit and continued it until 30 weeks of gestation and the pregnancy terminated in the cardiac operating room due to multiple episodes of chest pain. No complication occurred during her close observation before surgery. The aortic repair was performed for her after the cesarean section. CONCLUSION: Pregnancy with severe aortic root dilation is high-risk for all patients; however, if it occurs, when the mother denies an abortion, inform the patient about its risk and continue the pregnancy with close observation and tight blood pressure (BP) control until the fetus becomes viable. © 2021, Isfahan University of Medical Sciences(IUMS). All rights reserved.