CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Acute Type A Aortic Dissection Complicating Pregnancy: A Rare Case of Neri Type C with Right Coronary Ostial Involvement
Jing Wang
Lijuan Li
Ziwen Su
Rong Zhu
Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha, China
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Abstract
Rationale: Aortic dissection during pregnancy is a rare and catastrophic that poses an extreme threat to both maternal and fetus life. Case presentation: A 36-year-old female (gravida 2, para 1) at 35+5 weeks of gestation was transferred to our hospital with a 2-day history of acute chest tightness and discomfort. Computed tomography angiography (CTA) confirmed a Stanford type A aortic dissection, which extended to the brachiocephalic trunk and right coronary ostium, causing ascending and descending aortic dilatation, proximal right coronary artery compression and displacement, and moderate luminal narrowing. Electrocardiogram indicated inferior wall myocardial infarction. A diagnosis of pregnancy-associated acute type A aortic dissection complicated by acute myocardial infarction was made. Following multidisciplinary team evaluation, she underwent cesarean delivery under general anesthesia, resulting in the birth of a live female infant, followed immediately by cardiac surgery comprising a Bentall procedure, total arch replacement with frozen elephant trunk (Sun's procedure), and coronary artery bypass grafting. The operation succeeded, and one-month postoperative CTA revealed enlarged aortic true lumen without evidence of dissection in the three aortic arch branches. Conclusions: Acute Type A aortic dissection in pregnancy is a catastrophic event associated with high maternal and fetal mortality. Optimal survival depends on three critical factors: rapid diagnosis, coordinated multidisciplinary management, and meticulous, individualized surgical and perioperative care.
Summary
Keywords
Anesthesia, aortic dissection, Multidisciplinary care team, Pregnancy, Surgery
Received
28 August 2025
Accepted
05 February 2026
Copyright
© 2026 Wang, Li, Su and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Rong Zhu
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