Evidence map›Paper›PMID 40615390›Full record

ArticleNature communications2025

Connective tissue disorder and high risk pregnancy: a case series with personalised external aortic root support (PEARS).

Claudia Montanaro, Polona Kacar, Giulia Iannaccone, John Pepper, Gurleen Wander, Christoph A Nienaber, Andreas Hoschtitzky, Mario Petrou, Hannah Douglas, Mark R Johnson and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Claudia Montanaro *Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy's and St Thomas's NHS Trust, Sydney Street, London, UK. cmontanarocardiology@gmail.com.ORCID http://orcid.org/0000-0001-8613-8139
Polona Kacar *Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy's and St Thomas's NHS Trust, Sydney Street, London, UK.
Giulia IannacconeAdult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy's and St Thomas's NHS Trust, Sydney Street, London, UK.
John PepperNational Heart and Lung Institute, Imperial College, Dovehouse St, London, UK.
Gurleen WanderDepartment of Obstetrics, Chelsea and Westminster Hospital, 369 Fulham Road, London, UK.
Christoph A NienaberNational Heart and Lung Institute, Imperial College, Dovehouse St, London, UK.ORCID http://orcid.org/0000-0001-9671-8030
Andreas HoschtitzkyNational Heart and Lung Institute, Imperial College, Dovehouse St, London, UK.
Mario PetrouNational Heart and Lung Institute, Imperial College, Dovehouse St, London, UK.
Hannah DouglasDepartment of Cardiology, St Thomas' Hospital, London, UK.
Mark R JohnsonNational Heart and Lung Institute, Imperial College, Dovehouse St, London, UK.
Roshni R PatelDepartment of Obstetrics, Chelsea and Westminster Hospital, 369 Fulham Road, London, UK.
Isma RafiqAdult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy's and St Thomas's NHS Trust, Sydney Street, London, UK.
Michael A GatzoulisAdult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy's and St Thomas's NHS Trust, Sydney Street, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aortopathy including Marfan (MFS) and Loeys-Dietz syndrome (LDS) poses a high risk of aortic dissection, particularly during pregnancy and the puerperium. Current preventive measures of aortic root dilatation include medical therapy and prophylactic aortic root replacement. The Personalised External Aortic Root Support (PEARS) operation has been developed as an alternative surgical strategy to prevent aortic root dilatation and is now an established procedure with a good prognosis. However, outcomes in pregnant women are unknown. We present case series of nine successful pregnancies in seven women with aortopathy (6 MFS and 1 LDS) who underwent PEARS procedure prior to conception. At a mean follow-up of 4.3 years after delivery, there was no type A or B aortic dissections. Aortic dimensions remained stable, and no hypertensive disorders were observed. Although this is a small retrospective study, PEARS procedure may be a viable pre-conception surgical strategy for women with aortopathy, as an alternative to conventional aortic root surgery. Further studies are needed to conclude that PEARS could be a non-inferior or superior alternative to conventional aortic root surgery in these patients.

Indexed as

AortaConnective Tissue DiseasesLoeys-Dietz SyndromeMarfan SyndromePregnancy Complications, CardiovascularPregnancy, High-RiskAdultAortic DissectionFemaleHumansPregnancyPregnancy OutcomeRetrospective Studies

Identifiers

PMID40615390
PMCPMC12227734

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.