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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Cardiovascular Disorders 1/2014

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

Zeitschrift:
BMC Cardiovascular Disorders > Ausgabe 1/2014
Autoren:
Yoon-Jung Choi, Jang-Won Son, Sang-Hee Lee, Ung Kim, Dong-Gu Shin, Young-Jo Kim, Seung-Ho Hur, Chang-Wook Nam, Yun-Kyeong Cho, Bong-Ryul Lee, Byung-Chun Jeong, Jin-Bae Lee, Jae-Kean Ryu, Hun-Sik Park, Jang-Hoon Lee, Se-Yong Jang, Jong-Seon Park
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2261-14-103) contains supplementary material, which is available to authorized users.

Competing interests

The authors declared that they have no competing interests.

Authors’ contributions

YJC prepared all the data, acquisition of data, analysis and writing the draft, JWS participated in the data collection, analysis and interpretation of data, SHL participated in the data collection and discussion, UK participated in the data collection and discussion, DGS participated in the data collection, analysis and interpretation of data and revision, YJK participated in the data collection and supervised the acquisition of data, SHH participated in the data collection, CWN participated in the data collection, YKC participated in the data collection, BRL participated in the data collection, BCJ participated in the data collection, JBL participated in the data collection, JKR participated in the data collection, HSP participated in the data collection, JHL participated in the data collection, SYJ participated in the data collection and interpretation of CT images, JSP initiated the study and supervised the acquisition of data, helped the final approval of the version to be published and wrapped up the manuscript. All authors read and approved the final manuscript.

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.
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