Conclusion
Complicated TBAD in late pregnancy is a rapid onset and severe disease
that endangers the lives of both mother and fetus. Pregnant women with
increased blood pressure during pregnancy should be on the alert for AD.
Once obvious chest pain occurs, CTA should be performed to avoid missed
diagnosis and time consumption. The management of these patients
requires a multidisciplinary team, but the best course of action remains
debatable. Patients treated with TEVAR in this series revealed
satisfying short-term and midterm outcomes, providing a promising
treatment option for complicated TBAD in late pregnancy. Considering the
priority of maternal safety and the relative safety of TEVAR for the
fetus, we recommend that TEVAR can be performed before the delivery of
newborns. Specifically, for patients in the third trimester, a
single-stage delivery combined with thoracic endovascular aortic repair
is the preferred approach, and TEVAR should be conducted prior to
cesarean section. As for patients in the second trimester, pregnancy can
be continued if conditions of the mother and the fetus are
comprehensively evaluated and intensely monitored.
Acknowledgement: We would like to Jiafu Li, Jingpin Liu, for
their insight discussion and constructive comments on the manuscript.
Author contributions: SD: Investigation, Data collection,
Methodology. ZW, XCY: Visualization, Writing- Original draft
preparation. HJC, CL: Conceptualization, Writing-Reviewing and Editing,
Supervision. All authors critically reviewed and approved the final
version of the manuscript.
Funding: The authors received no financial support for the
research, authorship, and/or publication of this article.
Conflict of interests: None declared.
Ethics approval: This study was reviewed and approved by the
Medical Ethical Committee of Zhongnan Hospital of Wuhan University
(approval number 2023216K). Obtaining patient consent was not required
according to the committee’s procedures.
Data availability statement: Research data are not share.