[Aortic dissection in pregnancy in Marfan syndrome--case report and treatment concept].

PATIENTS AND

METHODS

Herein we report the case of a 37 year old pregnant women with Marfan syndrome with dilatation of the aorta ascendens of 42 mm preconceptionAl. The dilatation remained stable until 34 weeks of gestation when a aortic dissection (De Bakey type I) occurRed rapidly. The patient underwent a cesarean section and hysterectomy, followed by surgery of the aorta asc. by means of implantation of a valved graft immediately.

CONCLUSIONS

The criteria of a dilatation of the aorta ascendens < 40 mm does not identify reliably those patients who are at risk of dissection during pregnancy. A interdisciplinary approach together with obstetricians, cardiologists and cardiac surgeons is mandatory in all cases of Marfan syndrome and pregnancy.