Emergency vascular surgical care in populations with unique physiologic characteristics: Pediatric, pregnant, and frail populations

Warner, David L.; Holmes, Kathryn W.; RanaAfifi,; Russo, Melissa L.; Shalhub, Sherene

doi:10.1053/j.semvascsurg.2023.04.015

Cited by 3 publications

(1 citation statement)

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“…While there is no formal definition for what constitutes an AD associated with pregnancy, previous literature suggests a timeline which extends from conception to 6–12 weeks postpartum ( 1 - 4 ). AD during pregnancy can be due to genetic aortopathy, sporadic, or traumatic aortic injury ( 5 ). This review aims to provide an overview of genetic conditions associated with aortopathy, obstetric risks, and management strategies to assist in the optimization of patient care, and to highlight special clinical scenarios related to AD in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Obstetric considerations for aortopathy in pregnancy

Whelan,

Ringel,

Shalhub

et al. 2023

Ann Cardiothorac Surg

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Aortic dissection (AD) associated with pregnancy can have catastrophic consequences for the mother and/or fetus. AD occurs in 4–5 per 1,000,000 pregnancies and, despite its rarity, is the third most frequent maternal cardiovascular cause of death. AD associated with pregnancy is most likely to occur in the third trimester or postpartum period. In individuals with genetic aortopathy, pregnancy is considered a high-risk time for AD. There are management strategies in the preconception, antepartum, delivery and postpartum periods to optimize patient care. A multi-disciplinary team that includes capability to perform cardiovascular surgery is critical. Imaging modalities including maternal echocardiogram and magnetic resonance imaging can be safely performed in pregnancy for surveillance of the aortic size. Computed tomography (CT) scan is reserved for scenarios where there is a high index of suspicion for AD in a pregnant person to limit fetal exposure to radiation. After counseling about the potential risks of a pregnancy, the decision to pursue pregnancy is ultimately at the discretion of the individual. The duty of the cardio-obstetric team is to ensure that the patient and their family understand the risks of a pregnancy and the plan of care.

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Section: Introductionmentioning

confidence: 99%