PMID: 11345372May 10, 2001Paper

Different clinical features of aortic intramural hematoma versus dissection involving the ascending aorta

Journal of the American College of Cardiology
J K SongS J Park

Abstract

The goal of this study was to test the hypothesis that the absence of direct flow communication through intimal tear in aortic intramural hematoma (AIH) involving the ascending aorta has different clinical impact on clinical course compared with typical aortic dissection (AD). Although emergent surgical repair has been applied for patients with proximal AIH as if it was typical AD, the natural history of proximal AIH is not known clearly yet. Direct comparison of the clinical data of 81 patients with proximal AD and 24 patients with AIH was performed retrospectively. Patients with AIH were older (67 +/- 10 vs. 50 +/- 13, p = 0.001), and female gender was more predominant in AIH (19/24 vs. 29/81, p = 0.001). The development of mediastinal hemorrhage and pericardial and pleural effusion was more frequent in patients with AIH than it was in patients with AD. Although medical treatment was more frequently selected in the AIH group (75% vs. 15%, p = 0.001) due to old age and other associated medical diseases, the mortality rate with medical treatment was much lower in patients with AIH than it was in patients with AD (6% vs. 58%, p = 0.003). In follow-up imaging studies of 13 patients who survived AIH without surgical repair, seven ...Continue Reading

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