Bicuspid aortic valve and aortic bulb dilatation in pregnancy: a case report

Bicuspid aortic valve and aortic bulb dilatation in pregnancy: a case report
Alessia SalaOrcid, Stefano RestainoOrcid , Luigi VetrugnoOrcid, Martina BertoniOrcid, Emiliano Bacchetti
Orcid, Francesco VenturelliOrcid, Lorenza Driul1,2 – Orcid

1 – Department of Medicine, Clinic of Obstetrics and Gynecology, University of Udine

2 – Maternal and Child Department, Clinic of Obstetrics and Gynecology, Friuli Centrale University Health Authority

3 -Department of anesthesia and resuscitation, Clinic of anesthesia and resuscitation, Friuli Centrale University Healthcare Company

4 – Department of Medicine, University of Udine

Corresponding Author: Lorenza Driul

lorenza.driul@uniud.it


DOI: 10.53146/lriog1202145

Abstract

BACKGROUND: the number of women with cardiovascular diseases is increa- sing, especially in Western countries, where maternal heart disease is the le- ading cause of maternal death during pregnancy. The progressive increasing of maternal age is associated with a high risk in developing a cardiovascular risk factors and consequently cardiovascular disorders.
CASE REPORT: we present the case of a 39 years old pregnant patient with a bicuspid aortic valve and severe dilatation of the aortic root (50 mm). The patient was referred to the high-risk pregnancy service. A multidisciplina- ry team, composed by gynaecologist, cardiologist, cardiothoracic surgeon, anaesthetist and neonatologist, followed every phase of patient’s pregnancy. During the third trimester, an elective caesarean section was programmed in the cardiothoracic surgery operating room, with the aim to reduce the possi- ble risk both for the mother and for the foetus. However, she presented at 34 week and 4 days with uterine contractions, and an urgent caesareans section was performed: a male of 2980gr was born. DISCUSSION: pregnancy is responsible of physiological cardiovascular altera- tions during pregnancy, which may be responsible for serious consequences on the mother, especially if concomitant cardiovascular diseases are present. Considering bicuspid aortic valve, pregnancy should be avoided when aorta diameter is more than 50 mm. This case shows that a multidisciplinary team and adequate monitoring and a good clinical practice may be fundamental in reducing maternal and foetal risks.

Keywords: valvola aortica bicuspide; VAB; gravidanza; dilatazione bulbo aortico.


Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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