In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection
In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD). We reviewed our database of AAD to identify all eligible female patients. Women aged
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| Veröffentlicht in: | Journal of vascular surgery 2021-10, Vol.74 (4), p.1135-1142.e1 |
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| creator | Rommens, Kenton L. Sandhu, Harleen K. Miller, Charles C. Cecchi, Alana C. Prakash, Siddharth K. Saqib, Naveed U. Charlton-Ouw, Kristofer M. Milewicz, Dianna M. Estrera, Anthony L. Safi, Hazim J. Afifi, Rana O. |
| description | In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD).
We reviewed our database of AAD to identify all eligible female patients. Women aged |
| doi_str_mv | 10.1016/j.jvs.2021.03.028 |
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| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_proquest_miscellaneous_2514603465</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0741521421004924</els_id><sourcerecordid>2514603465</sourcerecordid><originalsourceid>FETCH-LOGICAL-c396t-4ee0f8483c663e58b2a3936b2e451a4ecd3ef55fa60cd0a6fb3e49f3fbd1e96e3</originalsourceid><addsrcrecordid>eNqNkM-L1DAUgIMo7uzqH-BFehSk9eVH0xRPMui6sOBFzyFNX2YytM2YtDPsf2_KjHsUT3nwvu9BPkLeUagoUPnpUB1OqWLAaAW8AqZekA2FtimlgvYl2UAjaFkzKm7IbUoHAEpr1bwmN5wrKRRTG6IfpnIf0tHPZijCMtswYirM1BdDmHbljHEs0hJP_rTuXXHO-2kd7N4PfYcm-mlXmB0WZz_vCxPi7G3R-5TQzj5Mb8grZ4aEb6_vHfn17evP7ffy8cf9w_bLY2l5K-dSIIJTQnErJcdadczwlsuOoaipEWh7jq6unZFgezDSdRxF67jreoqtRH5HPlzuHmP4vWCa9eiTxWEwE4YlaVZTIYELWWeUXlAbQ0oRnT5GP5r4pCnotas-6NxVr101cJ27Zuf99fzSjdg_G39DZkBdgDN2wSXrcbL4jAFAA02Oz_JE2TbXXuNswzLNWf34_2qmP19ozDVPHqO-Gr2PObnug__HP_4ApRmrGQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2514603465</pqid></control><display><type>article</type><title>In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>Access via ScienceDirect (Elsevier)</source><creator>Rommens, Kenton L. ; Sandhu, Harleen K. ; Miller, Charles C. ; Cecchi, Alana C. ; Prakash, Siddharth K. ; Saqib, Naveed U. ; Charlton-Ouw, Kristofer M. ; Milewicz, Dianna M. ; Estrera, Anthony L. ; Safi, Hazim J. ; Afifi, Rana O.</creator><creatorcontrib>Rommens, Kenton L. ; Sandhu, Harleen K. ; Miller, Charles C. ; Cecchi, Alana C. ; Prakash, Siddharth K. ; Saqib, Naveed U. ; Charlton-Ouw, Kristofer M. ; Milewicz, Dianna M. ; Estrera, Anthony L. ; Safi, Hazim J. ; Afifi, Rana O.</creatorcontrib><description>In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD).
We reviewed our database of AAD to identify all eligible female patients. Women aged <45 years were included. Data on pregnancy timing with respect to the occurrence of dissection, the demographic data, dissection extent, dissection treatment, dissection-related outcomes, overall maternal and fetal mortality, and genetic testing results were analyzed.
A total of 62 women aged <45 years had presented to us with AAD from 1999 to 2017. Of the 62 women, 37 (60%) had had a history of pregnancy at AAD. Of these 37 patients, 10 (27%) had had a peripartum aortic dissection, defined as dissection during pregnancy or within 12 months postpartum. Of the 10 AADs, 5 were type A and 5 were type B. Three patients had presented with AAD during pregnancy (one in the second and two in the third trimester). Five patients (50%) had developed AAD in the immediate postpartum period (within 3 months) and two (20%) in the late postpartum period. For the immediate postpartum AADs (<3 months), four of the five patients delivered via cesarean section. Of these 10 peripartum AADs, 3 (30%) had occurred in patients with known Marfan syndrome. In-hospital mortality for those with peripartum AAD was 10% (1 of 10). Fetal mortality was 20% (2 of 10).
The frequency of aortic dissection in women of childbearing age at our institution was low. However, pregnancy might increase the risk of those young women genetically predisposed to dissection events. From these data, this risk appears to be greatest in the immediate postpartum period, even for those who undergo cesarean section. Close clinical and radiographic surveillance is required for all women with suspected aortopathy, especially in the third trimester and early postpartum period.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2021.03.028</identifier><identifier>PMID: 33864828</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Adult ; Aneurysm, Dissecting - diagnostic imaging ; Aneurysm, Dissecting - epidemiology ; Aneurysm, Dissecting - mortality ; Aneurysm, Dissecting - therapy ; Aortic Aneurysm - diagnostic imaging ; Aortic Aneurysm - epidemiology ; Aortic Aneurysm - mortality ; Aortic Aneurysm - therapy ; Cardiovascular System & Cardiology ; Childbearing age ; Databases, Factual ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Life Sciences & Biomedicine ; Maternal Age ; Maternal Mortality ; Middle Aged ; Peripartum aortic dissection ; Peripheral Vascular Disease ; Pregnancy ; Pregnancy Complications, Cardiovascular - diagnostic imaging ; Pregnancy Complications, Cardiovascular - epidemiology ; Pregnancy Complications, Cardiovascular - mortality ; Pregnancy Complications, Cardiovascular - therapy ; Prognosis ; Reproductive Health ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Science & Technology ; Surgery ; Texas - epidemiology ; Time Factors</subject><ispartof>Journal of vascular surgery, 2021-10, Vol.74 (4), p.1135-1142.e1</ispartof><rights>2021 Society for Vascular Surgery</rights><rights>Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>8</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000707158200012</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c396t-4ee0f8483c663e58b2a3936b2e451a4ecd3ef55fa60cd0a6fb3e49f3fbd1e96e3</citedby><cites>FETCH-LOGICAL-c396t-4ee0f8483c663e58b2a3936b2e451a4ecd3ef55fa60cd0a6fb3e49f3fbd1e96e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2021.03.028$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,39263,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33864828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rommens, Kenton L.</creatorcontrib><creatorcontrib>Sandhu, Harleen K.</creatorcontrib><creatorcontrib>Miller, Charles C.</creatorcontrib><creatorcontrib>Cecchi, Alana C.</creatorcontrib><creatorcontrib>Prakash, Siddharth K.</creatorcontrib><creatorcontrib>Saqib, Naveed U.</creatorcontrib><creatorcontrib>Charlton-Ouw, Kristofer M.</creatorcontrib><creatorcontrib>Milewicz, Dianna M.</creatorcontrib><creatorcontrib>Estrera, Anthony L.</creatorcontrib><creatorcontrib>Safi, Hazim J.</creatorcontrib><creatorcontrib>Afifi, Rana O.</creatorcontrib><title>In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection</title><title>Journal of vascular surgery</title><addtitle>J VASC SURG</addtitle><addtitle>J Vasc Surg</addtitle><description>In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD).
We reviewed our database of AAD to identify all eligible female patients. Women aged <45 years were included. Data on pregnancy timing with respect to the occurrence of dissection, the demographic data, dissection extent, dissection treatment, dissection-related outcomes, overall maternal and fetal mortality, and genetic testing results were analyzed.
A total of 62 women aged <45 years had presented to us with AAD from 1999 to 2017. Of the 62 women, 37 (60%) had had a history of pregnancy at AAD. Of these 37 patients, 10 (27%) had had a peripartum aortic dissection, defined as dissection during pregnancy or within 12 months postpartum. Of the 10 AADs, 5 were type A and 5 were type B. Three patients had presented with AAD during pregnancy (one in the second and two in the third trimester). Five patients (50%) had developed AAD in the immediate postpartum period (within 3 months) and two (20%) in the late postpartum period. For the immediate postpartum AADs (<3 months), four of the five patients delivered via cesarean section. Of these 10 peripartum AADs, 3 (30%) had occurred in patients with known Marfan syndrome. In-hospital mortality for those with peripartum AAD was 10% (1 of 10). Fetal mortality was 20% (2 of 10).
The frequency of aortic dissection in women of childbearing age at our institution was low. However, pregnancy might increase the risk of those young women genetically predisposed to dissection events. From these data, this risk appears to be greatest in the immediate postpartum period, even for those who undergo cesarean section. Close clinical and radiographic surveillance is required for all women with suspected aortopathy, especially in the third trimester and early postpartum period.</description><subject>Adult</subject><subject>Aneurysm, Dissecting - diagnostic imaging</subject><subject>Aneurysm, Dissecting - epidemiology</subject><subject>Aneurysm, Dissecting - mortality</subject><subject>Aneurysm, Dissecting - therapy</subject><subject>Aortic Aneurysm - diagnostic imaging</subject><subject>Aortic Aneurysm - epidemiology</subject><subject>Aortic Aneurysm - mortality</subject><subject>Aortic Aneurysm - therapy</subject><subject>Cardiovascular System & Cardiology</subject><subject>Childbearing age</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Maternal Age</subject><subject>Maternal Mortality</subject><subject>Middle Aged</subject><subject>Peripartum aortic dissection</subject><subject>Peripheral Vascular Disease</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - diagnostic imaging</subject><subject>Pregnancy Complications, Cardiovascular - epidemiology</subject><subject>Pregnancy Complications, Cardiovascular - mortality</subject><subject>Pregnancy Complications, Cardiovascular - therapy</subject><subject>Prognosis</subject><subject>Reproductive Health</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Texas - epidemiology</subject><subject>Time Factors</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkM-L1DAUgIMo7uzqH-BFehSk9eVH0xRPMui6sOBFzyFNX2YytM2YtDPsf2_KjHsUT3nwvu9BPkLeUagoUPnpUB1OqWLAaAW8AqZekA2FtimlgvYl2UAjaFkzKm7IbUoHAEpr1bwmN5wrKRRTG6IfpnIf0tHPZijCMtswYirM1BdDmHbljHEs0hJP_rTuXXHO-2kd7N4PfYcm-mlXmB0WZz_vCxPi7G3R-5TQzj5Mb8grZ4aEb6_vHfn17evP7ffy8cf9w_bLY2l5K-dSIIJTQnErJcdadczwlsuOoaipEWh7jq6unZFgezDSdRxF67jreoqtRH5HPlzuHmP4vWCa9eiTxWEwE4YlaVZTIYELWWeUXlAbQ0oRnT5GP5r4pCnotas-6NxVr101cJ27Zuf99fzSjdg_G39DZkBdgDN2wSXrcbL4jAFAA02Oz_JE2TbXXuNswzLNWf34_2qmP19ozDVPHqO-Gr2PObnug__HP_4ApRmrGQ</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Rommens, Kenton L.</creator><creator>Sandhu, Harleen K.</creator><creator>Miller, Charles C.</creator><creator>Cecchi, Alana C.</creator><creator>Prakash, Siddharth K.</creator><creator>Saqib, Naveed U.</creator><creator>Charlton-Ouw, Kristofer M.</creator><creator>Milewicz, Dianna M.</creator><creator>Estrera, Anthony L.</creator><creator>Safi, Hazim J.</creator><creator>Afifi, Rana O.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>95M</scope><scope>AFTVD</scope><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202110</creationdate><title>In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection</title><author>Rommens, Kenton L. ; Sandhu, Harleen K. ; Miller, Charles C. ; Cecchi, Alana C. ; Prakash, Siddharth K. ; Saqib, Naveed U. ; Charlton-Ouw, Kristofer M. ; Milewicz, Dianna M. ; Estrera, Anthony L. ; Safi, Hazim J. ; Afifi, Rana O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-4ee0f8483c663e58b2a3936b2e451a4ecd3ef55fa60cd0a6fb3e49f3fbd1e96e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aneurysm, Dissecting - diagnostic imaging</topic><topic>Aneurysm, Dissecting - epidemiology</topic><topic>Aneurysm, Dissecting - mortality</topic><topic>Aneurysm, Dissecting - therapy</topic><topic>Aortic Aneurysm - diagnostic imaging</topic><topic>Aortic Aneurysm - epidemiology</topic><topic>Aortic Aneurysm - mortality</topic><topic>Aortic Aneurysm - therapy</topic><topic>Cardiovascular System & Cardiology</topic><topic>Childbearing age</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Maternal Age</topic><topic>Maternal Mortality</topic><topic>Middle Aged</topic><topic>Peripartum aortic dissection</topic><topic>Peripheral Vascular Disease</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - diagnostic imaging</topic><topic>Pregnancy Complications, Cardiovascular - epidemiology</topic><topic>Pregnancy Complications, Cardiovascular - mortality</topic><topic>Pregnancy Complications, Cardiovascular - therapy</topic><topic>Prognosis</topic><topic>Reproductive Health</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Texas - epidemiology</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rommens, Kenton L.</creatorcontrib><creatorcontrib>Sandhu, Harleen K.</creatorcontrib><creatorcontrib>Miller, Charles C.</creatorcontrib><creatorcontrib>Cecchi, Alana C.</creatorcontrib><creatorcontrib>Prakash, Siddharth K.</creatorcontrib><creatorcontrib>Saqib, Naveed U.</creatorcontrib><creatorcontrib>Charlton-Ouw, Kristofer M.</creatorcontrib><creatorcontrib>Milewicz, Dianna M.</creatorcontrib><creatorcontrib>Estrera, Anthony L.</creatorcontrib><creatorcontrib>Safi, Hazim J.</creatorcontrib><creatorcontrib>Afifi, Rana O.</creatorcontrib><collection>Conference Proceedings Citation Index - Science (CPCI-S)</collection><collection>Conference Proceedings Citation Index - Science (CPCI-S) 2021</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rommens, Kenton L.</au><au>Sandhu, Harleen K.</au><au>Miller, Charles C.</au><au>Cecchi, Alana C.</au><au>Prakash, Siddharth K.</au><au>Saqib, Naveed U.</au><au>Charlton-Ouw, Kristofer M.</au><au>Milewicz, Dianna M.</au><au>Estrera, Anthony L.</au><au>Safi, Hazim J.</au><au>Afifi, Rana O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection</atitle><jtitle>Journal of vascular surgery</jtitle><stitle>J VASC SURG</stitle><addtitle>J Vasc Surg</addtitle><date>2021-10</date><risdate>2021</risdate><volume>74</volume><issue>4</issue><spage>1135</spage><epage>1142.e1</epage><pages>1135-1142.e1</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>In the present study, we defined the outcomes and effects of pregnancy in a cohort of women of childbearing age with acute aortic dissection (AAD).
We reviewed our database of AAD to identify all eligible female patients. Women aged <45 years were included. Data on pregnancy timing with respect to the occurrence of dissection, the demographic data, dissection extent, dissection treatment, dissection-related outcomes, overall maternal and fetal mortality, and genetic testing results were analyzed.
A total of 62 women aged <45 years had presented to us with AAD from 1999 to 2017. Of the 62 women, 37 (60%) had had a history of pregnancy at AAD. Of these 37 patients, 10 (27%) had had a peripartum aortic dissection, defined as dissection during pregnancy or within 12 months postpartum. Of the 10 AADs, 5 were type A and 5 were type B. Three patients had presented with AAD during pregnancy (one in the second and two in the third trimester). Five patients (50%) had developed AAD in the immediate postpartum period (within 3 months) and two (20%) in the late postpartum period. For the immediate postpartum AADs (<3 months), four of the five patients delivered via cesarean section. Of these 10 peripartum AADs, 3 (30%) had occurred in patients with known Marfan syndrome. In-hospital mortality for those with peripartum AAD was 10% (1 of 10). Fetal mortality was 20% (2 of 10).
The frequency of aortic dissection in women of childbearing age at our institution was low. However, pregnancy might increase the risk of those young women genetically predisposed to dissection events. From these data, this risk appears to be greatest in the immediate postpartum period, even for those who undergo cesarean section. Close clinical and radiographic surveillance is required for all women with suspected aortopathy, especially in the third trimester and early postpartum period.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>33864828</pmid><doi>10.1016/j.jvs.2021.03.028</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aneurysm, Dissecting - diagnostic imaging Aneurysm, Dissecting - epidemiology Aneurysm, Dissecting - mortality Aneurysm, Dissecting - therapy Aortic Aneurysm - diagnostic imaging Aortic Aneurysm - epidemiology Aortic Aneurysm - mortality Aortic Aneurysm - therapy Cardiovascular System & Cardiology Childbearing age Databases, Factual Female Hospital Mortality Hospitalization Humans Life Sciences & Biomedicine Maternal Age Maternal Mortality Middle Aged Peripartum aortic dissection Peripheral Vascular Disease Pregnancy Pregnancy Complications, Cardiovascular - diagnostic imaging Pregnancy Complications, Cardiovascular - epidemiology Pregnancy Complications, Cardiovascular - mortality Pregnancy Complications, Cardiovascular - therapy Prognosis Reproductive Health Retrospective Studies Risk Assessment Risk Factors Science & Technology Surgery Texas - epidemiology Time Factors |
| title | In-hospital outcomes and long-term survival of women of childbearing age with aortic dissection |
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