Prashant Rao1, Eric M Isselbacher2. 1. Massachusetts General Hospital, 55 Fruit St., YAW-5800, Boston, MA, 02114, USA. 2. Massachusetts General Hospital, 55 Fruit St., YAW-5800, Boston, MA, 02114, USA. eisselbacher@mgh.harvard.edu.
Abstract
PURPOSE OF THE REVIEW: Acute aortic dissection is a potentially catastrophic cardiovascular emergency that is associated with a high mortality rate. Pregnancy, with its attendant hormonal and physiological changes, increases the risk of dissection in women with known thoracic aortic aneurysms. In this review, we highlight the importance of preconception counseling to help women with known thoracic aortic aneurysms better understand their risk of dissection and the heritable nature of thoracic aortic disease and its associated syndromes. RECENT FINDINGS: The risk of aortic dissection during pregnancy differs according to the underlying etiology of thoracic aortic aneurysm and the degree of aortic dilatation at baseline. Guideline-specific management of women with thoracic aortic aneurysms in pregnancy reduces their risk of dissection. Management of pregnant women with thoracic aortic aneurysms requires an intensive multidisciplinary approach to maximize the chances of a successful outcome for both the mother and fetus. Preconception counseling provides an opportunity to optimize patients medically and to consider potential prophylactic aortic repair prior to pregnancy.
PURPOSE OF THE REVIEW: Acute aortic dissection is a potentially catastrophic cardiovascular emergency that is associated with a high mortality rate. Pregnancy, with its attendant hormonal and physiological changes, increases the risk of dissection in women with known thoracic aortic aneurysms. In this review, we highlight the importance of preconception counseling to help women with known thoracic aortic aneurysms better understand their risk of dissection and the heritable nature of thoracic aortic disease and its associated syndromes. RECENT FINDINGS: The risk of aortic dissection during pregnancy differs according to the underlying etiology of thoracic aortic aneurysm and the degree of aortic dilatation at baseline. Guideline-specific management of women with thoracic aortic aneurysms in pregnancy reduces their risk of dissection. Management of pregnant women with thoracic aortic aneurysms requires an intensive multidisciplinary approach to maximize the chances of a successful outcome for both the mother and fetus. Preconception counseling provides an opportunity to optimize patients medically and to consider potential prophylactic aortic repair prior to pregnancy.
Authors: Lilian J Meijboom; Willem Drenthen; Petronella G Pieper; Maarten Groenink; Joris A M van der Post; Janneke Timmermans; Adriaan A Voors; Jolien W Roos-Hesselink; Dirk J van Veldhuisen; Barbara J M Mulder Journal: Int J Cardiol Date: 2005-10-19 Impact factor: 4.164
Authors: Joshua S Vapnik; Joon Bum Kim; Eric M Isselbacher; Brian B Ghoshhajra; Yisha Cheng; Thoralf M Sundt; Thomas E MacGillivray; Richard P Cambria; Mark E Lindsay Journal: Am J Cardiol Date: 2016-03-02 Impact factor: 2.778
Authors: Bart L Loeys; Ulrike Schwarze; Tammy Holm; Bert L Callewaert; George H Thomas; Hariyadarshi Pannu; Julie F De Backer; Gretchen L Oswald; Sofie Symoens; Sylvie Manouvrier; Amy E Roberts; Francesca Faravelli; M Alba Greco; Reed E Pyeritz; Dianna M Milewicz; Paul J Coucke; Duke E Cameron; Alan C Braverman; Peter H Byers; Anne M De Paepe; Harry C Dietz Journal: N Engl J Med Date: 2006-08-24 Impact factor: 91.245
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