Medical professionals at Vigo's Álvaro Cunqueiro Hospital faced an unprecedented medical challenge on May 1st when a 24-week pregnant patient was admitted with an acute aortic syndrome. The patient suffered from a type A aortic dissection, considered the most severe variant of this condition, where the inner wall of the body's main artery tears, allowing blood to seep between the layers of the aorta. This medical emergency carries extremely high mortality rates within the first hours of onset.
The situation presented a critical dilemma for the medical team. Given the gravity of the mother's condition and considering fetal viability options at 24 weeks gestation, the medical team made the unprecedented decision to perform cardiovascular surgery without prior cesarean section. This approach recognized that performing an emergency C-section at this stage of pregnancy would carry high risks of severe complications or non-survival for the fetus, while delaying treatment endangered the mother's life with each passing moment.
The complex surgical procedure involved opening the chest through a sternotomy and implementing temporary circulatory arrest for approximately 30 minutes. Using extracorporeal circulation technology, the team temporarily replaced the functions of the heart and lungs while preserving the vital organs of both mother and fetus through controlled hypothermia at 28°C and strict blood pressure management. The surgical team was led by cardiac surgeons Francisco Estévez and Rocío Casais, with anesthesiologists José Luis Barteiro and Iria de la Torre, supported by a multidisciplinary group of healthcare professionals.
The patient showed favorable recovery and was discharged from the hospital 14 days after the procedure, with the pregnancy continuing successfully. According to the Galician Health Service, this represents the first documented case in Galicia where circulatory arrest surgery has been performed on a pregnant patient. The successful outcome demonstrates significant medical advancement in handling complex cardiovascular emergencies during pregnancy, potentially establishing new protocols for similar cases in the future.
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