516 posters, 59 topics, 63 sessions, 1,127 authors, 352 institutions
ePostersLive by SciGen Technologies S.A. All rights reserved.
2026 SOAP Annual Meeting
April 29 - May 3, 2026 | Montreal, Quebec Canada
2331464
Cesarean Section for Parturients with Ascending Aortic Aneurysm: Two Case Reports with Anesthetic Recommendations
Poster Presenter
Authors
Affiliations
Part of Topic
OB EMERGENCIES
Cesarean Section for Parturients with Ascending Aortic Aneurysm:Two Case Reports with Anesthetic Recommendations
Physiologic changes of pregnancy & Aortic disease
Elective cesarean avoids valsalva during vaginaldelivery that may lead to rupture or dissection
Absolute indication: aortic diameter > 45 mm
Consider: aortic diameter 40-45 mm
|
Prophylactic aortic root surgery recommendations
|
|
|
Marfan's syndrome |
>4.5 cm 4.0–4.5 cm if there are other risk factors present (family history of aortic dissection, rapid aortic growth >3 mm/year) |
|
Bicuspid aortic valve |
≥5.0 cm |
|
Turner syndrome |
≥2.5 cm/m2 |
|
Loeys-Dietz syndrome |
≥4.0 cm if TGFBR1, TGFBR2, SMAD3 variants ≥4.5 cm if TGFB2, TGFB3 variants |
|
Non-syndromic heritable thoracic aortic aneurysm disease |
≥4.5 cm
|
CASE 1
32yo G1P0 with Marfan’s Syndrome and aorticroot dilatation, stable at 43mm duringpregnancy. She was on 25mg metoprololdaily with adequate HR and BPcontrol. Elective c/s at 37 weeks under GA.
-
Pre-induction A-line, RSI
-
Oxytocin IM, carboprost, TXA, EBL 1L
-
Cardiac step-down -> Postpartum POD1
CASE 2
39yo G1P0 with chronic hypertension andcongenital bicuspid aortic valve with aortic rootdilation, stable at 44mm during pregnancy. Shewas on 75mg metoprolol daily and was up-titrated in the 3rd trimester to 100mg daily forBP control. Elective c/s at 37 weeks under GA.
-
Pre-induction A-line, RSI
-
Oxytocin IM, EBL 500 mL intra-op
-
PPH in PACU -> carbropost, misoprostal, 2uPRBC, Jada placed, total EBL 2L
-
Cardiac step-down -> Postpartum POD1
Teaching Points
Limited literature on pregnancy and ascending aortic aneursym. A team approachwith multidisciplinary meeting (MDM) is critical to plan for safe delivery andpostpartum recovery.
-
Cesarean is often indicated for aortic diameter -> Neuraxial or GETA are bothsafe
-
Choice of neuraxial technique should plan for a slow load to avoid precipitousdrops in BP and reflex tachycardia.
-
With general anesthesia, attention should be taken to avoid hypertension andtachycardia during laryngoscopy and intubation.
-
With both anesthetics, close hemodynamic management is necessary to avoiddevastating complications from aortic aneurysms.