Liu LW, Luo L, Li L, Li Y, Jin M, Zhu JM. Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report . World J Clin Cases 2021; 9(15): 3644-3648 [PMID: 34046464 DOI: 10.12998/wjcc.v9.i15.3644]
Corresponding Author of This Article
Jun-Ming Zhu, MD, Professor, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China. anzhenzjm@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Cases. May 26, 2021; 9(15): 3644-3648 Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3644
Combined cesarean delivery and repair of acute aortic dissection at 34 weeks of pregnancy during COVID-19 outbreak: A case report
Li-Wei Liu, Lan Luo, Lu Li, Yu Li, Mu Jin, Jun-Ming Zhu
Li-Wei Liu, Lan Luo, Lu Li, Mu Jin, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Li-Wei Liu, Mu Jin, Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Yu Li, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Jun-Ming Zhu, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Author contributions: Liu LW, Luo L, and Li L contributed equally to this work; Li Y, Jin M, and Zhu JM designed the research study; Liu LW, Luo L, and Li L performed the research; Li Y, Jin M and Zhu JM wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: This study was approved by the Ethics Committee of the Beijing Anzhen Hospital Clinical Research (Beijing, China), and written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Jun-Ming Zhu, MD, Professor, Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China. anzhenzjm@163.com
Received: January 17, 2021 Peer-review started: January 17, 2021 First decision: February 11, 2021 Revised: March 16, 2021 Accepted: April 6, 2021 Article in press: April 6, 2021 Published online: May 26, 2021
Abstract
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 34th 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.
Core Tip: The findings indicated that the procedure described is viable in patients with combined cesarean delivery and Stanford type-A acute aortic dissection surgery during the coronavirus disease 2019 outbreak. In this case, a reasonable operation plan, practical procedures, and close cooperation among all departments were the keys to successful management.
