Complicated type B aortic dissection in a pregnant woman with Marfan syndrome

TL;DR

A pregnant woman with Marfan syndrome experienced a complicated aortic dissection and required emergency multidisciplinary treatment to save her life and the baby's.

Contribution

This case highlights the successful hybrid management of a rare and complex aortic dissection in a pregnant patient with Marfan syndrome.

Findings

Emergency cesarean section and thoracic endovascular aortic repair were performed due to acute type B aortic dissection.

The patient developed a retrograde type A aortic dissection, which was surgically managed.

Molecular testing confirmed the diagnosis of Marfan syndrome.

Abstract

Marfan syndrome is a rare inherited connective tissue disorder that can result in significant morbidity and mortality. We report a case of a 29-year-old pregnant woman presenting with an acute type B aortic dissection. Owing to cardiopulmonary decompensation and intestinal malperfusion, she underwent an emergency cesarean section followed by left subclavian to carotid transposition and thoracic endovascular aortic repair that was complicated by a retrograde type A aortic dissection and was managed surgically. Molecular testing confirmed the diagnosis of Marfan syndrome. This case highlights that multidisciplinary and hybrid management of challenging cases of acute aortic syndromes can result in a favorable outcome.

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