Campens L, Baris L, Scott NS, et al. - The leading cause of death during pregnancy is cardiovascular disease with thoracic aortic dissection being one of the main causes. Researchers aimed at analyzing the maternal and fetal outcome of pregnancy in women with thoracic aortic disease. From the ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC), a prospective global registry, they identified data of 5,739 women with pre-existing cardiac disease. One hundred eighty nine patients (3.3%) had thoracic aortic disease; these comprised 50% patients with Marfan syndrome (MFS), 26% patients with a BAV, 8% patients with Turner syndrome, 2% patients with vascular Ehlers-Danlos syndrome and 11% patients with no underlying genetic defect or associated congenital heart defect. In 58% of patients, aortic dilatation was reported and in 6%, a history of aortic dissection was described. This ancillary analysis yields the largest prospective data review on pregnancy risk for cases with thoracic aortic disease. Overall good pregnancy outcomes were reported in women with thoracic aortic disease followed according to current guidelines.