CASE HISTORY – June 2015

Bentall procedure (graft replacement of the aortic valve and ascending aorta) during pregnancy in a patient with Turner syndrome. A Case Report

Authors: Anne Kirss, Pille Vaas, Sirje Kõvask, Arno Ruusalepp, Arvo Klaar

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Cardiac surgery during pregnancy is a highrisk procedure for the mother as well as for the fetus. Only a few aortic valve and aortic root surgeries during pregnancy have been described. According to literature data, fetal mortality rate is 20% when cardiopulmonary bypass is used. Intraprocedural hypothermia impairs uteroplacental perfusion and promotes uterine contractions. Maternal hyperkalemia may cause fetal bradycardia and distress.

We report a case of a 31-year-old patient with Turner syndrome with a 5cm aortic aneurysm and bicuspid aortic valve, first diagnosed during pregnancy. In the 13th week of gestation, Bentall procedure was performed (composite graft replacement of the aortic valve and ascending aorta). Pregnancy continued and at 36GW the patient gave birth by Caesarean section to a boy with a birth weight of 1950 g and an Apgar score of 8/9. At the age of five months the infant weighed 6.5 kg and had normal emotional development. The mother is also in good health.