Introduction The coronavirus disease 2019 (COVID‐19) causes a small proportion of patients to be admitted to intensive care units, where they sometimes require extracorporeal membrane oxygenation (ECMO). The literature on pregnant women with COVID‐19 who require ECMO is sparse. Case report We describe here the earliest‐fetal‐age pregnant patient with COVID‐19 who underwent ECMO yet reported, who kept her child while under close follow‐up with magnetic resonance imagery and ultrasound. Conclusion The management of acute respiratory distress syndrome (ARDS) in pregnant women, including ARDS secondary to COVID‐19 and those cases which are not eligible for fetal delivery, may benefit from the assistance of ECMO even in the early pregnancy.

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Introduction: Intraoperative rupture of an aortic root and ascending aortic aneurysm is rare. However rupture of the aneurysm in this group of patients is challenging and associated with fatal outcomes. Case Report: we report the case of a 31-year-old Marfan syndrome patient with a huge aortic root and ascending aortic aneurysm. Median sternotomy and vertical opening of the pericardium were performed. Aneurysm rupture occurred before cannulation on its anterior surface. Intra-operative and postoperative management were successful. There were no neurological, hemodynamic or hemorrhagic complications. Conclusion: Intra-operative aneurysm rupture is rare and challenging. However, fast bleeding control and cannulation is compulsory in the management in this situation.

Objective: to show major challenge, concerns about rheumatic valve disease surgery in Burundi and medium term results. Methods: Included in our study, all patients whom the diagnosis of rheumatic heart disease had been made and underwent open heart surgery abroad. Results: Middle age= 24, 72 ±11.8 years, 33 (61.1%) patients were female. The average duration of the follow up=3.46±1.61years. Mitral valve was the most affected (92.59%). The main surgical procedure was mitral valve replacement performed to 47 (94%) patients. During the follow up, 3(5.5%) patients died. Conclusion: Surgical management of rheumatic heart disease remains a major challenge in Burundi. Six areas of concerns must be considered to developp a local technique plateau.