Metachronous type III and type II acute aortic dissections in puerperium.

The case of a 30-year-old non-Marfan woman who developed a type III acute aortic dissection 5 days after delivery, followed within 16 h by an independent type II dissection, is reported. Preoperative CT scan imaging and TEE suggested metachronous type II and type III dissection. This was confirmed at surgery, where limited dissection of the aortic root without communication with the isthmic area via the aortic arch was evidenced. The patient underwent repair of the aortic root and adjacent ascending aorta and was medically treated for her type III dissection. This is the first report of metachronous acute aortic dissections in puerperium.