Aortic valve-sparing reimplantation and mitral repair in a pregnant, second trimester Marfan patient: Surgical decision

We describe a combined aortic valve-sparing reimplantation procedure and mitral valve repair in a 20-year-old pregnant Marfan patient who presented at 12 weeks' gestation with an asymptomatic 5.3-cm aortic root aneurysm and moderate mitral regurgitation. Because the risk of aortic dissection and worsening mitral regurgitation becomes significant in the third trimester, elective intervention was undertaken at 14 weeks' gestation. The mother recovered uneventfully, and the baby was delivered at term by cesarean section. This case supports early elective surgery in pregnant Marfan patients with aortic and mitral diseases to avoid potentially fatal cardiovascular complications later in the pregnancy.