HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Naotaka Motoyoshi Koichi Tabayashi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moizumi, Y. Articles by Tabayashi, K. Search for Related Content PubMed PubMed Citation Articles by Moizumi, Y. Articles by Tabayashi, K. Related Collections Great vessels

J Thorac Cardiovasc Surg 2004;127:421-427
© 2004 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Clinical features and long-term outcome of type A and type B intramural hematoma of the aorta

^a Division of Cardiovascular Surgery, Sendai City Medical Center, Sendai, Japan
^b Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan

Received for publication June 19, 2003; revisions received September 8, 2003; accepted for publication September 16, 2003.

^* Address for reprints: Yoshimasa Moizumi, MD, the Division of Cardiovascular Surgery, Sendai, City Medical Center, 5-22-1 Turugaya, Miyaginoku, Sendai, Miyagiken, Japan
moizumi{at}openhp.or.jp

OBJECTIVE: Most previous reports on intramural hematoma of the aorta have focused on the initial episode. The purpose of this study was to clarify the long-term outcome of intramural hematoma of the aorta.

METHODS: Ninety-four cases of intramural hematoma of the aorta (41 type A and 53 type B) were reviewed. There were 69 male and 25 female patients, and their mean age was 66.7 ± 8.7 years (range, 46-88 years).

RESULTS: Eleven (27%) of the patients with type A hematoma and 1 (2%) of the patients with type B hematoma underwent early surgical intervention. Others were treated medically, and the overall hospital mortality was 7% for patients with type versus 2% for patients with type B intramural hematomas of the aorta (P = .315). Twenty-three patients, 9 (22%) with type A and 14 (26%) with type B intramural hematomas of the aorta, underwent late surgical intervention during the follow-up period, and there were no hospital deaths. A total of 23 patients died during the follow-up period, including 6 of intramural hematoma of the aorta–related deaths (3 in the type A group and 3 in the type B group). The estimated freedom from intramural hematoma of the aorta–related events at 1 and 5 years was 70% ± 8% and 54% ± 11% for the type A group versus 73% ± 6% and 58% ± 8% for the type B group, respectively (P = .972). After excluding the nonintramural hematoma of the aorta–related deaths, the survival rates at 5 and 10 years were 80% ± 9% and 80% ± 9% for the type A group and 91% ± 8% and 81% ± 11% for the type B group (P = .211).

CONCLUSIONS: Intramural hematoma of the aorta–related events occur equally in both types of intramural hematoma of the aorta. We recommend close follow-up for at least 5 years because most intramural hematoma of the aorta–related events occur during this period.

This article has been cited by other articles:

				K.-H. Park, C. Lim, J. H. Choi, K. Sung, K. Kim, Y. T. Lee, and P. W. Park Prevalence of Aortic Intimal Defect in Surgically Treated Acute Type A Intramural Hematoma Ann. Thorac. Surg., November 1, 2008; 86(5): 1494 - 1500. [Abstract] [Full Text] [PDF]

				C.-B. Kan, R.-Y. Chang, and J.-P. Chang Optimal initial treatment and clinical outcome of type A aortic intramural hematoma: a clinical review Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1002 - 1006. [Abstract] [Full Text] [PDF]

				T. T. Tsai, C. A. Nienaber, and K. A. Eagle Acute Aortic Syndromes Circulation, December 13, 2005; 112(24): 3802 - 3813. [Full Text] [PDF]

				M. Pocar, R. Di Bartolomeo, and F. Donatelli Type A aortic intramural haematoma vs. dissection Eur. Heart J., July 1, 2005; 26(13): 1342 - 1342. [Full Text] [PDF]

				A. Evangelista, D. Mukherjee, R. H. Mehta, P. T. O'Gara, R. Fattori, J. V. Cooper, D. E. Smith, J. K. Oh, S. Hutchison, U. Sechtem, et al. Acute Intramural Hematoma of the Aorta: A Mystery in Evolution Circulation, March 1, 2005; 111(8): 1063 - 1070. [Abstract] [Full Text] [PDF]

				C. Savini, F. Casselman, M. U. Ergenoglu, I. Degrieck, F. Van Praet, R. De Geest, F. Wellens, H. Jeanmart, and H. Vanermen Surgical management of progression to type A dissection from an intramural hematoma previously treated with endovascular stent graft placement J. Thorac. Cardiovasc. Surg., November 1, 2004; 128(5): 773 - 775. [Full Text] [PDF]