In this study, type A aortic dissections were associated with a dilated aorta, and type B aortic dissections often were not. Most pregnancy-related aortic dissection is due to an aortopathy often not diagnosed until after aortic dissection. Twenty-eight women (97%) survived aortic dissection hospitalization.Īortic dissection complicating pregnancy is rare. Aortopathy was not recognized until after aortic dissection in 47% of the women. Twenty women (69%) had an aortopathy condition or a positive family history: 13 women (65%) with Marfan syndrome, 2 women (10%) with Loeys-Dietz syndrome, 2 women (10%) with bicuspid aortic valves, 2 women (10%) with a family history of aortic disease, and 1 woman (5%) with familial thoracic aortic aneurysm. At type B aortic dissection diagnosis, the mean (SD) descending aortic diameter was 32.5 (5) mm. At type A aortic dissection diagnosis, the mean (SD) aortic diameters were sinus of Valsalva, 54.5 (5) mm and ascending aorta, 54.7 (6) mm. Aortic dissection onset was known in 27 women (93%): 15 during pregnancy, 4 in the first trimester, and 11 in the third trimester 12 were post partum, occurring a mean (SD) of 12.5 (14) days post partum. Thirteen women (45%) had type A aortic dissection, and 16 women (55%) had type B. Among women younger than 35 years, aortic dissection was related to pregnancy in 20 of 105 women (19%). The multicenter referral center study included 29 women with aortic dissection during pregnancy or less than 12 weeks post partum in IRAD from 1998 to 2018.Ĭlinical features of pregnancy-related aortic dissection to be studied included underlying aortopathy, aortic size, type of aortic dissection, timing of dissection, hypertension, and previous aortic surgery.Ī total of 29 women (mean age, 32 years) had pregnancy-related aortic dissection, representing 0.3% of all aortic dissections and 1% of aortic dissection in women in the IRAD. To examine the clinical characteristics, imaging features, and outcomes in women with pregnancy-related acute aortic dissection.Ī cohort study, comprising data from the International Registry of Acute Aortic Dissection (IRAD) (February 1, 1998, to February 28, 2018). Women with aortopathy conditions are at risk for pregnancy-related aortic dissection, and these conditions may not be recognized until after the aortic dissection occurs. 20 Cardiovascular Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston.19 Cardiovascular Division, Department of Medicine, University of Michigan School of Medicine, Ann Arbor.17 Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.16 Department of Cardiology, Hadassah University Medical Center, Jerusalem, Israel.15 Division of Cardiothoracic Surgery, Department of Baylor College of Medicine, Houston, Texas.14 Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.13 University Hospital of Heidelberg, Heidelberg, Germany.12 Department of Clinical Medicine, Tromsø University Hospital, Tromsø, Norway.11 Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.10 Department of Surgery University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada.9 Cardiovascular Division, Department of Medicine, University of Minnesota School of Medicine, Minneapolis.8 Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.7 Department of Anesthesiology, University of Virginia Medical School, Charlottesville.6 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, New York, New York.5 Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia.4 University Hospital Vall d'Hebron, Barcelona, Spain.3 Minneapolis Heart Institute at Abbott-Northwestern Hospital, Minneapolis, Minnesota.2 Medical student, Washington University School of Medicine in St Louis, St Louis, Missouri. 1 Cardiovascular Division, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri.
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