Marfan syndrome presenting with abdominal aortic aneurysm during pregnancy

We report a case of successfully performed Caesarean section followed by reconstruction of the abdominal aorta in a patient with Marfan syndrome.

A 35-year-old woman at 37 weeks’ gestation in her second pregnancy was referred with abdominal aortic aneurysm. On admission she was asymptomatic, haemodynamically stable, and without clinical and radiological signs of rupture. Magnetic resonance imaging confirmed that the infrarenal aortic aneurysm continued to the right common iliac artery. Following preoperative assessment, it was decided to finalize gestation and reconstruct the aorta in a one-stage procedure. After a median xyphopubic laparotomy, Mizgav–Ladach Caesarean section and Pomeroy tubal sterilization were performed, followed by aneurysmectomy and aorto-bilateral iliac artery bypass. The postoperative course was uneventful. Both mother and child were doing well at follow-up 3, 9 and 12 months after the intervention.

To the best of our knowledge, this is the first case of true abdominal aortic aneurysm repair and Caesarean section as a one-stage procedure.