AATS 2024 | Presentation by Junming Zhu & Suwei Chen: Type A aortic coarctation in pregnancy: management strategies and outcomes of 60 patients over a 25-year period
时间: 2024-05-21
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On April 28, Canadian local time, Professor Suwei Chen of the Department of Cardiac Macrovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, was invited to give an attention-grabbing presentation at the 104th Annual Meeting of the American Association for Thoracic Surgery (AATS), “Type A aortic dissection during pregnancy and postpartum: Management strategies and outcomes in 60 patients over 25 years” (Type A aortic dissection during pregnancy and postpartum: Management strategies and outcomes in 60 patients over 25 years): Management strategies and outcomes in 60 patients over 25 years” (Type A aortic dissection during pregnancy and postpartum: Management strategies and outcomes in 60 patients over 25 years).
Photos from the AATS 2024 conference
Founded in 1917, the American Association for Thoracic Surgery (AATS) hosts one of the most influential specialty meetings in the field of thoracic surgery, attracting top thoracic surgeons, researchers, and healthcare professionals from all over the world to discuss the latest advances and future trends in the field of thoracic surgery.At the AATS Congress, Prof. Suwei Chen introduced the valuable experience of multidisciplinary collaboration in the aortic surgery department of Beijing Anzhen Hospital in the diagnosis and treatment of complicated and rare aortic diseases such as type A aortic coarctation in pregnancy to cardiac macrovascular surgery experts and colleagues from all over the world.
Prof. Chen Suwei's on-site speech
Type A aortic coarctation in pregnancy: experience of a multidisciplinary team in aortic surgery at Beijing Anzhen Hospital
This is a retrospective study conducted by a multidisciplinary team of aortic surgery led by Profs. Lizhong Sun and Junming Zhu at Beijing Anzhen Hospital, which included patients diagnosed with pregnancy combined with type A aortic dissection (TAAD) between June 1998 and August 2023.The study was conducted by a multidisciplinary team of aortic surgeons from Beijing Anzhen Hospital.
A total of 60 patients with TAAD combined with pregnancy were included, with a mean gestational age of (30.3 ± 8.5) weeks and a mean age of (31.4 ± 5.0) years. Among them, 41 patients (68.4%) were in late pregnancy and puerperium; 39 patients (65%) were diagnosed with Marfan's syndrome and 13 had a positive family history.Management strategies were developed according to gestational weeks (GWs): 1 (1.7%) TAAD patient requested medication, and 29 (48.3%) of the remaining 59 (98.3%) patients had contemporaneous interventions; delivery priority was used in 18 (30%), with aortic repair after a median of 6.2 days; aortic repair priority was given to 12 (20%), with delivery after a median of 9.5 days.aternal and fetal mortality rates in the delivery-priority, contemporaneous intervention, and aortic repair-priority groups were 11.1% (2/18), 11.1% (2/18); 3.4% (1/29), 22.6% (7/31); 16.7% (2/12), and 66.7% (8/12), respectively; one patient requested conservative treatment, and the patient and fetus died of aortic dissection 5 days later .The follow-up completion rate was 98.1% (53/54), with a median follow-up of 4.1 years, and a total of 5 maternal and 2 fetal deaths. An additional 5 patients underwent 6 reoperations. The overall 6-year maternal and fetal survival rates were 82% and 67.7%, respectively.The results of this study suggest that week-of-gestation-based management of combined type A aortic coarctation in pregnancy maximizes simultaneous maternal and fetal life-saving and may provide a favorable near- and long-term prognosis.Dr. Steven L. Lansman, a renowned professor, commented on the presentation, highlighting that the study population is the world's largest known cohort of pregnant women with type A aortic coarctation, and that its diagnostic and treatment strategies and findings fill a gap in the international diagnostic and treatment landscape, and provide reliable and strong clinical evidence for the effective management of this type of disease, which is of great clinical significance.Diagnostic and therapeutic strategies in pregnancy combined with type A aortic coarctation
In the past 25 years, Anzhen team has gone through the difficult exploration period of “mother preservation + abandonment of fetus + removal of uterus” and “delivery priority + mother preservation + fetus preservation + uterus cutting”, and has now realized the “mother preservation + fetus preservation + uterus preservation The clinical and therapeutic problems of “motherhood + fertility preservation + uterus preservation” have now been realized. In the past 8 years, the survival rate of fetus after 28 gestational weeks is as high as 97.5%, and the maternal survival rate reaches 100%. Nowadays, the multidisciplinary department of aortic surgery in Beijing Anzhen Hospital is exploring hard towards saving fetuses smaller than 28 gestational weeks, or even in early pregnancy.About the Multidisciplinary Team of Aortic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Beijing Anzhen Hospital affiliated to Capital Medical University is the National Clinical Medical Research Center for Cardiovascular Diseases, and is the center for aortic surgery with the largest operation volume and the most comprehensive technology in China. It has been committed to solving all kinds of complex and difficult aortic diseases, and has established a three-dimensional multidisciplinary team of aortic surgery, including anesthesiology, extracorporeal circulation, intensive care medicine, obstetrics and gynecology, neonatology, thoracic surgery and general surgery, etc. The team has formed a mature and comprehensive aortic surgery team after more than 20 years of unremitting efforts.After more than 20 years of unremitting efforts, a mature multidisciplinary diagnosis and treatment system and management strategy have been formed. We have rich perioperative experience in thoracic and abdominal aortic aneurysms, infectious and immunogenic aortic diseases, rare congenital aortic anatomical anomalies, and aortic diseases associated with pregnancy, and have published many relevant studies in international cardiac surgery journals and Chinese core journals, etc. A number of research results have been incorporated into international guidelines and expert consensus, and a series of China's clinical diagnosis and treatment of aortic diseases have been authored, He has also authored a series of expert consensus on clinical diagnosis and treatment of aortic diseases, surgical techniques and perioperative management in China.
The outstanding performance of the cardiac macrovascular surgery team of Beijing Anzhen Hospital of Capital Medical University at the AATS Congress not only enhanced the image of Chinese scholars in the international arena, but also contributed to the “Chinese solution” for the multidisciplinary collaboration in managing complex and difficult aortic diseases. We look forward to more Chinese medical teams going abroad to share their “Chinese wisdom” in the future.Outpatient Information:
Zhu Junming Tuesday-Thursday morning special needs clinic
Su-Wei Chen Friday morning team clinic of the second ward of aortic surgery
Correspondence should be addressed to ZHU Jun-Ming
Beijing Anzhen Hospital of Capital Medical University
M.D., Chief Physician, Second Class Professor, Director of the Adult Cardiac Surgery Center of Beijing Anzhen Hospital affiliated with Capital Medical University, Vice Chairman of the Department of Cardiac Surgery of Capital Medical University. Currently, he is the vice chairman of the Cardiovascular Surgery Physicians Branch of the Chinese Medical Doctors' Association, the chairman of the National Specialized Committee of Large Vessel Surgery, and the vice chairman of the Cardiovascular Surgery Technology and Engineering Branch of the China Pharmaceutical and Biotechnology Association. In the past five years, he was awarded the first prize of Huaxia Medical Science and Technology Award in 2023 and the second prize of Beijing Scientific and Technological Progress Award in 2020, and was selected as the “Scientific, Technological and Management Talents with Outstanding Contributions in Beijing” in 2023. He has been awarded 13 national invention and utility model patents. He has been in charge of formulating and participating in the publication of 9 national and international diagnostic and treatment standards and consensus. He has participated in the publication of 134 SCI papers on clinical diagnosis and treatment techniques and pathogenesis of aortic diseases, which have been cited in many international monographs and guidelines.
Conference presentations : Chen Suwi
Beijing Anzhen Hospital of Capital Medical University
D., attending physician of the Second Ward of Aortic Surgery Center of Beijing Anzhen Hospital affiliated with Capital Medical University, graduated from Capital Medical University in 2021, and was awarded the title of Outstanding Graduate of Provincial and Ministerial Levels in school. In the same year, she entered the postdoctoral station of Beijing Anzhen Hospital to continue her clinical and basic research in aortic surgery, and is committed to solving the clinical diagnosis and treatment problems of complex aortic diseases through interdisciplinary approach. He has participated in the writing and reporting of many national and provincial projects. Currently, she has published 11 SCI and Chinese core articles as the first author, participated in 3 conference speeches and poster presentations, and authored 1 monograph.
