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Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report

BACKGROUND: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetu...

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Autores principales: Liu, Li-Wei, Luo, Lan, Li, Lu, Li, Yu, Jin, Mu, Zhu, Jun-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130093/
https://www.ncbi.nlm.nih.gov/pubmed/34046464
http://dx.doi.org/10.12998/wjcc.v9.i15.3644
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author Liu, Li-Wei
Luo, Lan
Li, Lu
Li, Yu
Jin, Mu
Zhu, Jun-Ming
author_facet Liu, Li-Wei
Luo, Lan
Li, Lu
Li, Yu
Jin, Mu
Zhu, Jun-Ming
author_sort Liu, Li-Wei
collection PubMed
description BACKGROUND: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetus that requires emergency surgical treatment without the test for COVID-19. CASE SUMMARY: A 38-year-old woman without Marfan syndrome was admitted to the hospital because of chest pain in the 34(th) week of gestation. She has diagnosed as having a Stanford type-A AAD involving an aortic arch and descending aorta via aortic computed tomographic angiography. The patient was transferred to the isolated negative pressure operating room in one hour and underwent cesarean delivery and ascending aorta replacement. All medical staff adopted third-level medical protection measures throughout the patient transfer and surgical procedure. After surgery, the patient was transferred to the isolated negative pressure intensive care unit ward. The nucleic acid test and anti-COVID-19 immunoglobulin (Ig) G and IgM were performed and were negative. The patient and infant were discharged without complication nine days later and recovered uneventfully. CONCLUSION: The results indicated that the procedure that we used is feasible in patients with a combined cesarean delivery and surgery for Stanford type-A AAD during the COVID-19 outbreak, which was mainly attributed to rapid multidisciplinary consultation, collaboration, and quick decision-making.
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spelling pubmed-81300932021-05-26 Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report Liu, Li-Wei Luo, Lan Li, Lu Li, Yu Jin, Mu Zhu, Jun-Ming World J Clin Cases Case Report BACKGROUND: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetus that requires emergency surgical treatment without the test for COVID-19. CASE SUMMARY: A 38-year-old woman without Marfan syndrome was admitted to the hospital because of chest pain in the 34(th) week of gestation. She has diagnosed as having a Stanford type-A AAD involving an aortic arch and descending aorta via aortic computed tomographic angiography. The patient was transferred to the isolated negative pressure operating room in one hour and underwent cesarean delivery and ascending aorta replacement. All medical staff adopted third-level medical protection measures throughout the patient transfer and surgical procedure. After surgery, the patient was transferred to the isolated negative pressure intensive care unit ward. The nucleic acid test and anti-COVID-19 immunoglobulin (Ig) G and IgM were performed and were negative. The patient and infant were discharged without complication nine days later and recovered uneventfully. CONCLUSION: The results indicated that the procedure that we used is feasible in patients with a combined cesarean delivery and surgery for Stanford type-A AAD during the COVID-19 outbreak, which was mainly attributed to rapid multidisciplinary consultation, collaboration, and quick decision-making. Baishideng Publishing Group Inc 2021-05-26 2021-05-26 /pmc/articles/PMC8130093/ /pubmed/34046464 http://dx.doi.org/10.12998/wjcc.v9.i15.3644 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Liu, Li-Wei
Luo, Lan
Li, Lu
Li, Yu
Jin, Mu
Zhu, Jun-Ming
Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title_full Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title_fullStr Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title_full_unstemmed Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title_short Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
title_sort combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during covid-19 outbreak: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130093/
https://www.ncbi.nlm.nih.gov/pubmed/34046464
http://dx.doi.org/10.12998/wjcc.v9.i15.3644
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