Document Detail


Intermediate-term results of surgical treatment of acute intramural hematoma involving the ascending aorta.
MedLine Citation:
PMID:  18291183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The treatment strategy of acute intramural hematoma involving the ascending aorta remains uncertain. The objective of this study was to evaluate the effectiveness of surgical treatment for this condition. METHODS: A total of 41 patients underwent operation for acute intramural hematoma involving the ascending aorta between 2000 and 2006. Mean age was 67.2 +/- 10.1 years, with 26 female patients and 10 in cardiogenic shock at presentation. Early and midterm results, including mortality, morbidity, survival, event-free rates, and the persistence of residual hematoma, were analyzed retrospectively in all patients. Mean follow-up period was 29.7 +/- 18.1 months. RESULTS: All but one patient underwent operation within 72 hours from the onset of symptoms. Thirty-four patients underwent isolated ascending aortic replacement, three had hemiarch repair, and four required total arch replacement. There were no in-hospital deaths. Stroke occurred in two patients and transient neurologic dysfunction in one. Postoperative computed tomographic scan showed residual distal hematoma progression to classical double-barrel dissection in two patients. At five years follow-up, survival was 100%. During the follow-up period, one patient had a new type B aortic dissection. A follow-up study confirmed hematoma resorption in 29 patients (70.7%). The estimated freedom from intramural hematoma-related events was 92.6 +/- 4.1% at five years. No independent predictor of intramural hematoma-related events was found on multivariate analysis. CONCLUSIONS: Immediate surgical treatment of acute aortic intramural hematoma involving the ascending aorta with open distal replacement of ascending aorta results in lower mortality rates and excellent midterm survival.
Authors:
Tomoki Shimokawa; Naomi Ozawa; Shuichiro Takanashi; Tsuyoshi Itoh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  982-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. tshimokawa-circ@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aorta*
Aortic Diseases / surgery*
Cardiomyopathies / surgery*
Female
Hematoma / surgery*
Humans
Male
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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