Successful management of acute type A aortic dissection in the third trimester of pregnancy: A case report

Abstract

Acute type A aortic dissection during pregnancy is rare but life-threatening. It requires early multidisciplinary diagnosis and intervention to optimize maternal and fetal outcomes. We report the case of a 35-year-old woman (gravida 7 para 6) at 34 weeks of gestation who presented with epigastric pain, initially suspected to be gastroenteritis. Despite stable initial findings, her condition deteriorated and a CT angiogram confirmed the diagnosis of DeBakey Type I aortic dissection, which extended from the aortic root to the iliac arteries. She underwent an emergency cesarean section followed by a Bentall procedure, a surgical technique first described by Bentall and De Bono in 1968 to manage the aortic valve, root, and ascending aorta abnormalities. Both mother and baby survived, with an uneventful recovery. However, this case highlights the diagnostic challenges of aortic dissection in pregnancy, as non-specific symptoms can mimic benign conditions. Multidisciplinary management and timely surgical intervention are crucial for maternal and fetal survival.