Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3644
Peer-review started: January 17, 2021
First decision: February 11, 2021
Revised: March 16, 2021
Accepted: April 6, 2021
Article in press: April 6, 2021
Published online: May 26, 2021
Processing time: 113 Days and 21.8 Hours
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetus that requires emergency surgical treatment without the test for COVID-19.
A 38-year-old woman without Marfan syndrome was admitted to the hospital because of chest pain in the 34th week of gestation. She has diagnosed as having a Stanford type-A AAD involving an aortic arch and descending aorta via aortic computed tomographic angiography. The patient was transferred to the isolated negative pressure operating room in one hour and underwent cesarean delivery and ascending aorta replacement. All medical staff adopted third-level medical protection measures throughout the patient transfer and surgical procedure. After surgery, the patient was transferred to the isolated negative pressure intensive care unit ward. The nucleic acid test and anti-COVID-19 immunoglobulin (Ig) G and IgM were performed and were negative. The patient and infant were discharged without complication nine days later and recovered uneventfully.
The results indicated that the procedure that we used is feasible in patients with a combined cesarean delivery and surgery for Stanford type-A AAD during the COVID-19 outbreak, which was mainly attributed to rapid multidisciplinary consultation, collaboration, and quick decision-making.
Core Tip: The findings indicated that the procedure described is viable in patients with combined cesarean delivery and Stanford type-A acute aortic dissection surgery during the coronavirus disease 2019 outbreak. In this case, a reasonable operation plan, practical procedures, and close cooperation among all departments were the keys to successful management.