• Bmc Cardiovasc Disor · Jan 2014

    Multicenter Study

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

    • 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, and Jong-Seon Park.
    • Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, Republic of Korea. pjs@med.yu.ac.kr.
    • Bmc Cardiovasc Disor. 2014 Jan 1;14:103.

    BackgroundIntramural 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.MethodsWe 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.ResultsMost 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.ConclusionFor 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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