Speaker
Chao Liu
- Wuhan Asia Heart Hospital
- China
Presentation
Acute type A aortic dissection complicated with malperfusion syndrome during the puerperium: a case report
- April 22-23, 2027
- Paris, France
Biography
Chao Liu is affiliated with the Department of Anesthesiology at Wuhan Asia General Hospital and the School of Medicine, Wuhan University of Science and Technology, China. His professional interests are centered on anesthesiology and clinical medical research.
Abstract
Background: Pregnancy-related acute type A aortic dissection (ATAAD) complicated by malperfusion syndrome (MPS) is rare and life-threatening, with high risks of organ ischemia, bleeding, and perioperative coagulopathy.
Objectives: To summarize the rescue and perioperative management of a critically ill puerperal woman with ATAAD complicated by MPS and to identify practical strategies for improving outcomes.
Methodology: We report the clinical course, imaging findings, surgical treatment, postoperative complications, and multidisciplinary management of a 29-year-old woman who developed acute back pain one hour after delivery. CTA showed ATAAD with involvement of the coronary, cervical, subclavian, and superior mesenteric arteries and signs of visceral malperfusion.
Key Results/Findings: Emergency Bentall procedure, aortic arch branch vessel debranching, coronary artery bypass grafting, and thoracic endovascular aortic repair were performed under general anesthesia. Postoperatively, individualized coagulation monitoring and targeted transfusion were used to balance bleeding and thrombosis risks. Intestinal ischemia-reperfusion injury caused recurrent gastrointestinal bleeding; laparoscopic exploration revealed necrotic right colon, and right hemicolectomy with ileostomy was performed. After intensive care and multidisciplinary treatment, the patient stabilized, was discharged on postoperative day 45, and later underwent ileostomy reversal.
Conclusion: Rapid diagnosis, prompt revascularization, individualized coagulation management, early recognition of intestinal ischemia-reperfusion injury, and coordinated multidisciplinary care are essential for successful rescue in puerperal ATAAD with MPS.
