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Pernicious Pregnancy: Type B Aortic Dissection in Pregnant Women
  • +2
  • Lara Rimmer,
  • Sophie Mellor,
  • Amer Harky,
  • Mohamed Gouda,
  • Mohamad Bashir
Lara Rimmer
East Lancashire Hospitals NHS Trust
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Sophie Mellor
University of Birmingham College of Medical and Dental Sciences
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Amer Harky
Liverpool Heart and Chest Hospital NHS Foundation Trust
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Mohamed Gouda
Mataria Teaching Hospital
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Mohamad Bashir
East Lancashire Hospitals NHS Trust
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Abstract

Type B Aortic Dissection (TBAD) occurs seldomly in pregnancy, but has disastrous consequences for both mother and fetus. The focus of immediate surgical repair of Type A Aortic Dissection due to higher mortality of patients is less clear in its counterpart, TBAD, in which management is controversial and debated. Risk factors for TBAD include: aortic wall stress due to hypertension, previous cardiac surgery, structural abnormalities (bicuspid aortic valve, aortic coarctation), and connective tissue disorders. In pregnancy, pre-eclampsia is a cause of increased aortic wall stress. Management of this condition is often conservative, but this is dependent on a number of factors, including gestation, cardiovascular stability of the patient, and symptomology. In most cases, a Caesarean section prior to intervention is carried out, unless certain indications are present. Due to a scarce number of cases across decades, it is difficult to determine which management is optimal. This article collates knowledge so far on this rare event during pregnancy.

Peer review status:UNDER REVIEW

13 Aug 2020Submitted to Journal of Cardiac Surgery
17 Aug 2020Submission Checks Completed
17 Aug 2020Assigned to Editor
17 Aug 2020Reviewer(s) Assigned
23 Aug 2020Review(s) Completed, Editorial Evaluation Pending
23 Aug 2020Editorial Decision: Revise Minor
14 Sep 20201st Revision Received
23 Sep 2020Submission Checks Completed
23 Sep 2020Assigned to Editor
23 Sep 2020Reviewer(s) Assigned