Type A aortic dissection in a young 37 weeks pregnant lady successfully treated by Bentall procedure: A case report

Aortic dissection is intimal tear in aorta and collection of blood in between the layers of aortic wall. The incidence of acute type A aortic dissection is between 2.1 and 16.3 per 100,000 persons [1]. Aortic dissection is an infrequent but potentially life threatening complication of pregnancy with most of the cases occurring in third trimester and post-partum period [2]. The most important predisposing factors to aortic dissection are Marfan, Ehlers-Danlos, Turner and Loeys-Dietz syndromes [3]. However, the non sporadic cases can also occur in pregnancy [4]. In non sporadic cases, pregnancy itself predisposes to development of aortic dissection due to several physiologic hormonal and blood pressure changes. Still, the incidence of aortic dissection is very low in pregnancy with a study reporting it to be nearly 0.0004% [5]. Though aortic dissection is rare in pregnancy, its urgent treatment is mandatory due to very high risk of maternal and fetal death. The mortality rate increases 1 to 2% every hour in the first 48 hours if the necessary intervention is not done [6]. Bentall procedure is a surgical modality to repair aortic root and ascending aortic arch anomalies such as aneurysms and dissections. It is the treatment of choice for treating proximal aortic dissection [7].