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

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Author(s)
허승호남창욱조윤경
Alternative Author(s)
Hur, Seung HoNam, Chang WookCho, Yun Kyeong
Publication Year
2014
Abstract
Background
Intramural 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.


Methods

We 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.


Results

Most 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.


Conclusion

For 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.


Keywords
Intramural hematoma of the aorta – Survival rates – Treatment
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
BMC Cardiovascular Disorders, Vol.14(1) : 103-103, 2014
Type
Article
ISSN
1471-2261
DOI
10.1186/1471-2261-14-103
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35238
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