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Hemiarch aortic replacement for acute type A dissection in a Marfan patient with twin pregnancy

^a Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Louisville, 201 Abraham Flexner Way, Suite 1200, Louisville, KY 40202, USA
^b Department of Obstetrics and Gynecology, University of Louisville, Louisville, KY, USA

*Corresponding author. Fax: +1-502-561-2180/1-502-561-2190.

E-mail address: spagni{at}ucsamd.com (S. Pagni).

Type A aortic dissection is a high risk surgical emergency. Its occurrence during pregnancy represents an extremely high risk for death and sequelae for both the mother and the fetus. Surgical treatment in the form of cesarean delivery and aortic repair using hypothermia and circulatory arrest is mandatory in most patients. We report the case of a 29-year-old Marfan female with an acute type A aortic dissection at 34 weeks of a twin pregnancy. She underwent cesarean delivery of male twins followed by repair of the ascending aorta and proximal arch using deep hypothermia and circulatory arrest. The mother and twin babies survived without sequelae and are alive at two years.

Key Words: Marfan syndrome; Aortic dissection; Twin pregnancy