Intramural hematoma and dissection involving ascending aorta: the clinical features and prognosis

Motoyoshi, Naotaka; Moizumi, Yoshimasa; Komatsu, Tsunehiro; Tabayashi, Koichi

doi:10.1016/s1010-7940(03)00270-7

Cited by 41 publications

(30 citation statements)

References 13 publications

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“…A similar conclusion was reached by Song et al (9). The average age of patients presenting with intramural hematoma ranged from 58 to 71 years (median age: 68 years) (2,8,(10)(11)(12)(13)(14)(15), which is much older than the average of patients with classic AD (median age: 61 years) (16). The prevalence of Marfan syndrome is significantly lower in patients with intramural hematoma (9).…”

Section: Imh: a Precursor To Classic Dissection Or A Distinct Diseasesupporting

confidence: 62%

Aortic intramural hemorrhage: A distinct disease entity with mystery

Fei

et al. 2017

IRDR

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Section: Imh: a Precursor To Classic Dissection Or A Distinct Diseasesupporting

confidence: 62%

Aortic intramural hemorrhage: A distinct disease entity with mystery

Fei

et al. 2017

IRDR

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“…Moreover, a delayed operation in the initial medical treatment group was not infrequently needed; the operative frequency was 32% (25/79) in our study, which is intermediate between the previously reported frequencies of 27% (7/26) and 43% (13/30). 5,19 These findings reinforce the importance of thorough analysis to characterize the clinical features of any adverse event and to seek valuable predictors of such occurrences.…”

Section: Adverse Events Without Urgent Surgery and Prognostic Role Ofmentioning

confidence: 74%

“…5,19 However, the temporal pattern and its prognostic impact have not been investigated in detail. In the present study, AD developed in a rather random fashion within 2 months from initial symptom onset, and the risk of AD development seems not to be critically time dependent.…”

Section: Adverse Events Without Urgent Surgery and Prognostic Role Ofmentioning

confidence: 99%

Outcomes of Patients With Acute Type A Aortic Intramural Hematoma

et al. 2009

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Background-The proper treatment option for patients with type A intramural hematoma (IMH), a variant form of classic aortic dissection (AD), remains controversial. We assessed the outcome of our institutional policy of urgent surgery for unstable patients and initial medical treatment for stable patients with surgery in cases with complications. .56). The 1-, 2-, and 3-year survival rates of IMH patients were 87.6Ϯ3.6%, 84.9Ϯ3.7%, and 83.1Ϯ4.1%, respectively. There was no statistical difference of overall survival rates between patients with IMH and surgically treated AD patients (Pϭ0.787). Conclusions-The clinical outcome of IMH patients receiving treatment by our policy was comparable to that of surgically treated AD patients. However, adverse clinical events were not uncommon with medical treatment alone, and initial aorta diameter and hematoma thickness may identify patients who might benefit from urgent surgery.

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“…Our findings suggest the prognosis of type A IMH is not as benign as previously thought in Asian patients. Although prior Asian series 9 -11 have reported low death rates in type A IMH with medical therapy, a significant proportion [11][12][13] of patients (up to 50%) go on to develop serious complications and required urgent surgical intervention.…”

Section: Discussionmentioning

confidence: 95%

Type A Aortic Intramural Hematoma: Clinical Features and Outcomes in Chinese Patients

Cheung

Jim

et al. 2011

Clinical Cardiology

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Background: The purpose of this study was to describe the clinical characteristics and clinical outcomes for Chinese patients with type A intramural hematoma (IMH). Methods and Results:We studied 90 patients with Stanford type A acute aortic syndrome who presented to our institution from 1998 to 2005 and evaluated the presentation, management, and clinical outcomes of acute IMH by comparing these patients with those diagnosed with classical aortic dissection (AD). A total of 34 patients had IMH and they tended to be older (69.7±12.4 versus 60.5±16.2 years; p = 0.006). The development of pericardial effusion was more frequent in patients with IMH than in patients with AD. They were also less likely to receive surgery as compared to AD patients (26.5% versus 73.2%; p<0.0001). Overall mortality of IMH was not significantly higher than that of classic AD (29.4% versus 21.4%; p = 0.45). For IMH patients, the mortality rate with medical treatment was 32%. Ten (40%) of the 25 medically treated patients developed adverse outcomes. However, no independent predictors of adverse outcomes were identified in the study. In follow-up imaging studies of 15 patients who survived IMH without surgical repair, 14 patients showed complete resolution of IMH and 1 progressed into classical AD. Conclusion: Acute type A IMH in Chinese patients showed a high mortality rate with medical treatment. It has a highly unpredictable course with no reliable clinical and anatomical predictors. Surgical therapy should be the treatment of choice for Chinese patients with acute IMH, especially those who are younger and have less comorbidities.

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Intramural hematoma and dissection involving ascending aorta: the clinical features and prognosis

Cited by 41 publications

References 13 publications

Aortic intramural hemorrhage: A distinct disease entity with mystery

Aortic intramural hemorrhage: A distinct disease entity with mystery

Outcomes of Patients With Acute Type A Aortic Intramural Hematoma

Type A Aortic Intramural Hematoma: Clinical Features and Outcomes in Chinese Patients

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