Multidisciplinary Surgical Management for a Pregnant Patient With Acute Type A Aortic Dissection

BACKGROUND Type A aortic dissection during pregnancy, a rare and fatal clinical emergency, is highly challenging to the survival of both the mother and her fetus. In the obstetrical context, synchronous surgical repair of type A aortic dissection is both more critical and more difficult in clinical practice; therefore, multidisciplinary treatment is necessary. In our report, the treatment of acute type A aortic dissection during pregnancy is presented, with the aim to share clinical experience and provide clinical insights. CASE REPORT A 37-year-old pregnant patient (G3P1), admitted with a complaint of sudden severe pain in both chest and back for 2 hours, was diagnosed as having type A aortic dissection based on findings from imaging. After a comprehensive preoperative assessment, the patient underwent a combination emergent surgical procedure of cesarean section and repair of type A aortic dissection. During the emergent surgical procedure, the infant was safe and vital signs were stable throughout the cesarean section. Also, the repair of the aortic dissection was completed smoothly. Postoperatively, the outcomes for both mother and her baby were satisfactory as expected. CONCLUSIONS The case report mainly emphasizes the clinical significance of reliable and feasible treatment for acute type A aortic dissection during pregnancy. In view of higher mortality and incidence of perioperative complications in pregnant patients, an individual strategy based on preoperative assessment, intraoperative coordination, and postoperative management-- involving both obstetricians and cardiovascular surgeons-- can play a crucial role in successful intervention for this kind of complicated obstetric event during pregnancy.