Aortic dissection in the first trimester; is it a dead end? A narrative review of recent articles

INTRODUCTION

Acute-type aortic dissection (AD) during pregnancy is considered a rare and potentially fatal complication for both mother and fetus. Although the definite treatment for an acute-type AD is considered to be open-heart surgery, the decision to perform such a surgery during pregnancy requires a multidisciplinary approach and carries significant risks.

METHODS

In the present review of the literature, we have discussed various challenges in the management of acute-type AD during pregnancy, including therapeutic approaches, choosing the preferred imaging modalities, surgical techniques, and medication challenges. We have also reported an 8-week pregnant woman with Marfan syndrome who presented with chest pain and was diagnosed with acute AD.

RESULTS

The patient underwent a Bentall operation and was discharged in good condition with her fetus alive. The medical team's various decisions during preoperative, operative, and postoperative treatments were discussed.

CONCLUSIONS

Type A AD is considered infrequent in the second and third trimester of pregnancy and rare in the first trimester. Performing a CMR study without contrast in stable patients can help evaluate the extension of the flap. Urgent surgery in the hands of a skilled surgeon may prove lifesaving for the mother while maximizing the likelihood of preserving the fetus.

Cutaneous complications of parenteral pentazocine abuse

A 26-year-old man, a parenteral pentazocine abuser for past 10 years, presented with woody induration on the areas of injections and multiple, punched-out, deep, painless ulcers surrounded by hyperpigmented halo. This appears to be the first report from India on skin manifestations of pentazocine abuse.

Resolving the positive, negative, and neutral fluxes of an expanding, laser-produced plasma

The space-charge separation seen in an expanding, laser-produced plasma is a remnant of energetic electrons produced in anomalous laser absorption. In order to better understand this phenomenon, a Faraday cup collector has been devised which simultaneously records positive, negative, and neutral components of such an expanding plasma. The response of this detector to a laser-produced plasma is measured and compared to magnetically filtered ion collectors. This detector proves superior to the magnetic collector for energetic ions, but is limited to low plasma densities by collective effects.