Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematomaReport as inadecuate




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BMC Cardiovascular Disorders

, 14:103

Non-coronary artery cardiac disease

Abstract

BackgroundIntramural hematoma of the aorta IMH, a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data.

MethodsWe analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A n = 61, 37.0% and type B n = 104, 63.0% according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2 years.

ResultsMost of the patients 77.0% of type A and 99.0% of type B, P < 0.001 were treated medically during their initial hospitalization. There were no significant differences in in-hospital mortality 4.9% vs. 2.9%, P = 0.671 and 2-year mortality 13.1% vs. 11.5%, P = 0.765 between two groups. During the 2-year follow up period, progression to aortic dissection 18.0% vs. 6.7%, P = 0.037 and surgical treatment 29.5% vs. 2.9%, P < 0.001 were higher in type A. For the type A patients, there were no significant difference in in-hospital mortality 7.1% of surgery vs. 4.3% of medical, P = 0.428 and 2-year mortality 7.1% of surgery vs. 14.9% of medical, P = 0.450 in terms of initial treatment strategy.

ConclusionFor real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.

KeywordsIntramural hematoma of the aorta Survival rates Treatment AbbreviationsIMHIntramural hematoma of the aorta

CTComputed tomographic

MRMagnetic resonance

TEETransesophageal echocardiography.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-14-103 contains supplementary material, which is available to authorized users.

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Author: Yoon-Jung Choi - Jang-Won Son - Sang-Hee Lee - Ung Kim - Dong-Gu Shin - Young-Jo Kim - Seung-Ho Hur - Chang-Wook Nam - Yun

Source: https://link.springer.com/article/10.1186/1471-2261-14-103







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