دورية أكاديمية

In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection.

التفاصيل البيبلوغرافية
العنوان: In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection.
المؤلفون: Rommens KL; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Sandhu HK; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Miller CC 3rd; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Cecchi AC; Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Prakash SK; Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex; Division of Cardiology, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Saqib NU; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Charlton-Ouw KM; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Milewicz DM; Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Estrera AL; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Safi HJ; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex., Afifi RO; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Tex. Electronic address: Rana.O.Afifi@uth.tmc.edu.
المصدر: Journal of vascular surgery [J Vasc Surg] 2021 Oct; Vol. 74 (4), pp. 1135-1142.e1. Date of Electronic Publication: 2021 Apr 20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008-> : New York, NY : Elsevier
Original Publication: St. Louis, Mo. : Mosby, [c1984-
مواضيع طبية MeSH: Hospitalization* , Maternal Age* , Reproductive Health*, Aortic Dissection/*epidemiology , Aortic Aneurysm/*epidemiology , Pregnancy Complications, Cardiovascular/*epidemiology, Adult ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/mortality ; Aortic Dissection/therapy ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/mortality ; Aortic Aneurysm/therapy ; Databases, Factual ; Female ; Hospital Mortality ; Humans ; Maternal Mortality ; Middle Aged ; Pregnancy ; Pregnancy Complications, Cardiovascular/diagnostic imaging ; Pregnancy Complications, Cardiovascular/mortality ; Pregnancy Complications, Cardiovascular/therapy ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Texas/epidemiology ; Time Factors
مستخلص: Objective: In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD).
Methods: We reviewed our database of AAD to identify all eligible female patients. Women aged <45 years were included. Data on pregnancy timing with respect to the occurrence of dissection, the demographic data, dissection extent, dissection treatment, dissection-related outcomes, overall maternal and fetal mortality, and genetic testing results were analyzed.
Results: A total of 62 women aged <45 years had presented to us with AAD from 1999 to 2017. Of the 62 women, 37 (60%) had had a history of pregnancy at AAD. Of these 37 patients, 10 (27%) had had a peripartum aortic dissection, defined as dissection during pregnancy or within 12 months postpartum. Of the 10 AADs, 5 were type A and 5 were type B. Three patients had presented with AAD during pregnancy (one in the second and two in the third trimester). Five patients (50%) had developed AAD in the immediate postpartum period (within 3 months) and two (20%) in the late postpartum period. For the immediate postpartum AADs (<3 months), four of the five patients delivered via cesarean section. Of these 10 peripartum AADs, 3 (30%) had occurred in patients with known Marfan syndrome. In-hospital mortality for those with peripartum AAD was 10% (1 of 10). Fetal mortality was 20% (2 of 10).
Conclusions: The frequency of aortic dissection in women of childbearing age at our institution was low. However, pregnancy might increase the risk of those young women genetically predisposed to dissection events. From these data, this risk appears to be greatest in the immediate postpartum period, even for those who undergo cesarean section. Close clinical and radiographic surveillance is required for all women with suspected aortopathy, especially in the third trimester and early postpartum period.
(Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Childbearing age; Peripartum aortic dissection; Pregnancy
تواريخ الأحداث: Date Created: 20210417 Date Completed: 20211221 Latest Revision: 20221207
رمز التحديث: 20221213
DOI: 10.1016/j.jvs.2021.03.028
PMID: 33864828
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6809
DOI:10.1016/j.jvs.2021.03.028