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Management of anaesthesia in a parturient with acute aorticdissection


Authors: Leitgeb Marián;  Šmrha Radim;  Tesařík Richard;  Zmeko Dušan
Authors‘ workplace: ARO a RES KCH, Nemocnice České Budějovice, a. s.
Published in: Anest. intenziv. Med., 25, 2014, č. 5, s. 348-354
Category: Anaesthesiology - Case Reports

Overview

Acute aortic dissection is a life-threatening condition with high mortality rate. One of the many risk factors of this disease is the physiological pregnancy. It is necessary to make early diagnosis and start adequate treatment according to the needs of both the mother and the phoetus. We present a case of a pregnant woman at 33 weeks of gestation with type A dissection, and the management of general anaesthesia. Following a Caesarian Section, the ascending aorta was repaired.

Keywords:
aorta – aortic dissection – anaesthesia – pregnancy


Sources

1. Pitt, M. P., Bonser, R. S. The natural history of thoracic aortic aneurysm disease: an overview. Journal of Cardiac Surgery, 1997, 12, p. 270–278.

2. Zeebregts, C. J., Schepens, M. A., Hameeteman, T. M., Morshuis, W. J., Rivière, A. B. Acute Aortic Dissection Complicating Pregnancy. The Annals of Thoracic Surgery, 1997, 64, p. 1345–1348.

3. Vejvoda, J., Alan, D., Ošťádal, P. Disekce aorty. Intervenční a akutní kardiologie, 2005, 4, p. 159–165.

4. Manallo-Estrekka, P., Barker, A. E. Histopathologic findings in human aortic media assosiated with pregnancy. Archives of Pathology, 1967, 83, p. 336–341.

5. Wilson, S. K., Hutchins, G. M. Aortic dissection aneu-rysms: causative factors in 204 subjects. Archives of Pathology & Laboratory Medicine, 1982, 106, p. 175–180.

6. Thalmann, M., Sodeck, G. H., Domanovits, H., Grassberger, M., Loewe, C. H., Grimm, M., Czerny, M. Acute type A aortic dissection and pregnancy: A population-based study. European Journal of Cardio-thoracic Surgery, 2011, 39, p. 159–163.

7. ÚZIS ČR: Rodička a novorozenec 2012 [online]. Praha. Ústav zdravotnických informací a statistiky ČR, 2013 [cit. 2013-12-18]. Dostupné z WWW: http://www.uzis.cz/system/files/rodnov2012.pdf. ISBN 978-80-7472-087-1.

8. Thalmann, M., Sodeck, G. H., Domanovits, H. et al. Acute type A aortic dissection and pregnancy: A population-based study. European Journal of Cardiothoracic surgery, 2011, 39, p. 159–163.

9. Pineault, J., Ouimet, D., Pichette, V., Vallee, M. A case of an aortic dissection in a young adult: A refresher of the literature of this “great masquerader“. International Journal of General Medicine, 2011, 4, p. 889–893.

10. Vigil-De Gracia, P., Lasso, M., Ruiz, E., Vega-Malek, J. C., de Mena, F. T., López, J. C. Severe hypertension in pregnancy: hydralazin or labetalol: A randomized clinical trial. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2006, 128, p. 157–162.

11. Morse, B. C., Boland, B. N., Morse, J. N., Jones, Y. R., Simpson, J. P., Appleby, D. A., Davis, B. R., Taylor, S. M. DeBakey Type II Aortic Dissection: A Rare Catastrophic Complication of Pregnancy. The American Surgeon, 2014, 80, 3, p. 79–81.

12. Yuan, S. M. Aortic dissection during pregnancy: a difficult clinical scenario. Clinical Cardiology, 2013, 36, 10, p. 576–584.

13. Shihata, M., Pretorius, V., MacArthur, R. Cardiac general repair of an acute type A aortic dissection combined with an emergency cesarean section in a pregnant woman. Interactive CardioVascular and Thoracic Surgery, 2008, 7, p. 938–940.

14. Sepehripour, A. H., Lo, T. T., Shipolini, A. R., McCormack, D. J. Can pregnant women be safely placed on cardiopulmonary bypass? Interactive CardioVascular and Thoracic Surgery, 2012, 15, p. 1063–1071.

15. Regitz-Zagrosek, V., Blomstrom, L. C., Borghi, C. et al. ESC guidelines on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology. European Heart Journal, 2011, 32, p. 3147–3197.

16. Zitnik, R. S., Brandenburg, R. O., Sheldon, R., Wallace, R. B. Pregnancy and open heart surgery. Circulation, 1969, 39, 40, 1, p. 257–262.

17. Becker, R. M. Intracardiac surgery in pregnant women. The Annals of Thoracic Surgery, 1983, 36, p. 453–458.

18. Pomini, F., Mercogliano, D., Cavalletti, C., Caruso, A., Pomi-ni, P. Cardiopulmonary bypass in pregnancy. The Annals of Thoracic Surgery, 1996, 61, p. 259–268.

19. Reitman, E., Flood, P. Anaesthetic considerations for non-obstetric surgery during pregnancy. British Journal of Anaesthesia, 2011, 107 (S1), p. 72–78.

20. Horszczaruk, G. J., Roik, M. F., Kochman, J. et al. Aortic dis-section involving ostium of right coronary artery as the reason of myocardial infarction. European Heart Journal, 2006, 27, p. 518.

21. Mészáros, I., Mórocz, J., Szlávi, J. et al. Epidemiology and clinicopathology of aortic dissection. A population-based longitudinal study over 27 years. CHEST Journal, 2000, 117, p. 1271–1278.

22. Shiga, T., Wajima, Z., Apfel, C. C., Inoue, T., Ohe, Y. Diagnostic Accuracy of Transesophageal Echocardiography, Helical Computed Tomography, and Magnetic Resonance Imaging for Suspected Thoracic Aortic Dissection: Systematic Review and Meta-analysis. Archives of Internal Medicine, 2006, 166, 13, p. 1350–1356.

23. Meredith, E. L., Masani, N. D. Echocardiography in the emergency assessment of acute aortic syndromes. European Journal of Echocardiography, 2009, 10, p. 31–39.

24. Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Eagle, K. A., Hermann, L. K., Isselbacher, E. M., Kazerooni, E. A. et al. Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease. Journal of the American College of Cardiology, 2010, 55, 14, p. 27–129.

25. Ham, S. Emergency repair of Arotic Dissection in a 37-week parturient. AANA Journal, 2010, 78, p. 63–68.

26. Haas, S., Trepte, C., Rybczynski, M., Somville, T., Treede, H., Reuter, D. A. Type A aortic dissection during late pregnancy in a patient with Marfan syndrome. Canadian Journal of Anaesthesia, 2011, 58, p. 1024–1028.

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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