Anaesthetic challenges in emergency surgical repair of acute aortic dissection rupturing into the pericardium in a pregnant patient

Acute aortic dissection in pregnancy is a serious situation, because rapid and appropriate surgical decision making is required to save the life of both mother and baby. Aortic dissection is rare in young women but is likely during pregnancy (third trimester) secondary to the hyperdynamic and hyperv...

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Bibliographic Details
Published in:Journal of the Pakistan Medical Association 2011, Vol.61 (1), p.85-87
Main Authors: MOHAMMAD IRFAN AKHTAR, SAMAD, Khalid
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - surgery
Aortic Rupture - complications
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiopulmonary Bypass
Diseases of the aorta
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Emergencies
Factor VIIa - therapeutic use
Female
General aspects
Humans
Medical sciences
Pregnancy
Pregnancy Complications, Cardiovascular - therapy
Pregnancy Outcome
Treatment Outcome
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Summary:Acute aortic dissection in pregnancy is a serious situation, because rapid and appropriate surgical decision making is required to save the life of both mother and baby. Aortic dissection is rare in young women but is likely during pregnancy (third trimester) secondary to the hyperdynamic and hypervolaemic circulatory state associated with pregnancy. A 35 years old 27 weeks pregnant patient weighing 90 kg presented in the emergency with severe chest pain. In the immediate post cardiopulmonary bypass period, the patient started bleeding profusely from the anastamotic sites irrespective of utilization of all the conventional methods of haemostasis including multiple units of whole blood, fresh frozen plasma, platelets, calcium and cryoprecipitates. As a last resort she was given low dose r FVIIa (1.2 mg containing 60 KIU of Factor VII). This stopped the bleeding and the haemodyramics were stabilized.
ISSN:0030-9982