Copyright © 2004 by the European Society of Cardiology.
Clinical research
Prognostic value of clinical and morphologic findings in short-term evolution of aortic intramural haematoma
Therapeutic implications
a Servei de Cardiología, Hospital General Universitari Vall d'Hebron, Barcelona, Spain
b Institut de Diagnòstic per la Imatge, Hospital General Universitari Vall d'Hebron, Barcelona, Spain
* Correspondence to: Arturo Evangelista. Servei de Cardiología, Hospital General Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. Tel: 932 746 212; Fax 932 746 244
E-mail address: evangel{at}hg.vhebron.es
Received 31 January 2003; revised 3 October 2003; accepted 16 October 2003
Abstract
Aims Intramural haematoma (IMH) forms part of the acute aortic syndrome presenting physiopathologic and evolutive patterns different from those of aortic dissection. The aim of this study was to determine the mortality and predictive factors of IMH in the first 3 months of evolution.
Methods and results Sixty-eight consecutive patients diagnosed of IMH (12 type A, 56 type B) were prospectively studied. Ten patients (eight type A, two type B) were surgically treated for clinical or haemodynamic evolution. Mortality rate was 19% (six type A and seven type B): five surgically treated (three type A, two type B) and eight medically treated (three type A, five type B). No relationship was observed between clinical variables and evolution. Maximum aortic diameter was greater in the group of patients who died (65.5±14.4mm vs 46.0±7.6mm; P<0.0001). Mortality rate in patients with aortic diameter >50mm was 50% (P<0.0001). Significant periaortic bleeding was mortality-related (47%; P<0.005). Multivariate analysis showed only a significant relationship between mortality and maximum aortic diameter >50mm (OR=11.33; P<0.005) and ascending aorta involvement (OR=11.18; P<0.05).
Conclusion Intramural haematoma mortality in the first 3 months of evolution is high (19%). Maximum aortic diameter >50mm and ascending aorta involvement are predictive of early mortality.
Key Words: Aortic intramuralhaematoma • Aortic dissection • Prognosis • Magnetic resonanceimaging • Tomography • Transoesophageal echocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I Vilacosta, P Aragoncillo, V Canadas, J A San Roman, J Ferreiros, and E Rodriguez Acute aortic syndrome: a new look at an old conundrum Heart, July 15, 2009; 95(14): 1130 - 1139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. D. Patel and R. R. Arora Pathophysiology, diagnosis, and management of aortic dissection Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 439 - 468. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Minicucci, G. Galizia, L. Ascione, G. Granata, A. Scaglione, M. Accadia, S. Rumolo, and B. Tuccillo Iatrogenic aortic haematoma during primary PTCA: Diagnostic value of transesophageal echocardiography in cath lab Eur J Echocardiogr, October 1, 2006; 7(5): 390 - 393. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Ahmad, N Cheshire, and M Hamady Acute aortic syndrome: pathology and therapeutic strategies. Postgrad. Med. J., May 1, 2006; 82(967): 305 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Garzon, M. Fernandez-Velilla, M. Marti, I. Acitores, F. Ybanez, and L. Riera Endovascular Stent-Graft Treatment of Thoracic Aortic Disease RadioGraphics, October 1, 2005; 25(suppl_1): S229 - S244. [Abstract] [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 Type A aortic intramural haematoma vs. dissection: reply Eur. Heart J., July 1, 2005; 26(13): 1342 - 1343. [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]
|
|
|
|
|
|
H.P. Kuhl and P. Hanrath The impact of transesophageal echocardiography on daily clinical practice Eur J Echocardiogr, December 1, 2004; 5(6): 455 - 468. [Abstract] [Full Text] [PDF]
|
|