Successful Conservative Treatment of a Type A Aortic Intramural Hematoma

Vlastos, Dimitrios; Fernandes, Francisco; Chauhan, Ishaansinh; Mirsadraee, Saeed; Asimakopoulos, George

doi:10.1016/j.jaccas.2020.05.051

Cited by 2 publications

(2 citation statements)

References 10 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TAIMH is less likely to be associated with acute aortic insufficiency, coronary artery involvement or aortic root dilation [3]. However, the risk of rupture remains quite high, between 5% and 25% [3,6,7]. Regarding aneurysm formation, 20-35% of medically treated patients with TAIMH experience resolution during follow-up, without any further intervention [8][9][10].…”

Section: Natural Coursementioning

confidence: 99%

Ascending aortic intramural hematoma: current concepts

Nana

Kouvelos

Σπανός

2022

Current Opinion in Cardiology

View full text Add to dashboard Cite

Purpose of reviewType A intramural hematoma (TAIMH) is an acute aortic disease characterized by the presence of hematoma in the aortic media and involving the ascending aorta. Open repair seems to be the first treatment approach, although recent evidence highlights that the best management of TAIMH is controversial. This review will focus on the current concept for TAIMH management and factors affecting the decision making.Recent findingsRecent studies have evaluated the role of open and endovascular repair, as well as conservative management in patients with TAIMH. More specific imaging findings seem to affect decision making for urgent repair.SummaryDespite TAIMH's acute nature, conservative management seems to represent a valid option for urgent approach, presenting similar mortality to open and endovascular repair. Comparative data are limited, however, in experienced centers, any approach may be applied with encouraging results. Endovascular management, which is mainly applied to manage retrograde TAIMH, is related to lower mortality and morbidity compared to open repair in this group of patients while aortic remodeling seems beneficial with this approach. Imaging findings, as ulcer-like lesions, hematoma thickness, concomitant dissection and aortic diameter, related to higher complication rate, set the indication for interventional management. Further research, including prospective data and registries, and ideally, randomized data may further clarify the best approach and factors indicating urgent repair.

show abstract

Section: Natural Coursementioning

confidence: 99%

Ascending aortic intramural hematoma: current concepts

Nana

Kouvelos

Σπανός

2022

Current Opinion in Cardiology

View full text Add to dashboard Cite

show abstract

“…In this issue of JACC: Case Reports , Vlastos et al. ( 12 ) present a case of a patient with a subacute type A IMH. The diameter of the aortic root was 45 mm and ascending aorta 39 mm, and the maximal diameter of the hematoma of the ascending aorta was only 5 mm.…”

mentioning

confidence: 99%

Type A Intramural Hematoma

Isselbacher

2020

JACC: Case Reports

View full text Add to dashboard Cite

show abstract

Successful Conservative Treatment of a Type A Aortic Intramural Hematoma

Cited by 2 publications

References 10 publications

Ascending aortic intramural hematoma: current concepts

Ascending aortic intramural hematoma: current concepts

Type A Intramural Hematoma

Contact Info

Product

Resources

About