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Article: Type A aortic intramural hematoma: Clinical features and outcomes in Chinese patients

TitleType A aortic intramural hematoma: Clinical features and outcomes in Chinese patients
Authors
KeywordsAorta
Hematoma
Medical therapy
Mortality
Surgery
Issue Date2011
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
Citation
Clinical Cardiology, 2011, v. 34 n. 3, p. E1-E5 How to Cite?
Abstract
Background: The purpose of this study was to describe the clinical characteristics and clinical outcomes for Chinese patients with type A intramural hematoma (IMH). Methods and Results: We studied 90 patients with Stanford type A acute aortic syndrome who presented to our institution from 1998 to 2005 and evaluated the presentation, management, and clinical outcomes of acute IMH by comparing these patients with those diagnosed with classical aortic dissection (AD). A total of 34 patients had IMH and they tended to be older (69.7±12.4 versus 60.5±16.2 years; p = 0.006). The development of pericardial effusion was more frequent in patients with IMH than in patients with AD. They were also less likely to receive surgery as compared to AD patients (26.5% versus 73.2%; p<0.0001). Overall mortality of IMH was not significantly higher than that of classic AD (29.4% versus 21.4%; p = 0.45). For IMH patients, the mortality rate with medical treatment was 32%. Ten (40%) of the 25 medically treated patients developed adverse outcomes. However, no independent predictors of adverse outcomes were identified in the study. In follow-up imaging studies of 15 patients who survived IMH without surgical repair, 14 patients showed complete resolution of IMH and 1 progressed into classical AD. Conclusion: Acute type A IMH in Chinese patients showed a high mortality rate with medical treatment. It has a highly unpredictable course with no reliable clinical and anatomical predictors. Surgical therapy should be the treatment of choice for Chinese patients with acute IMH, especially those who are younger and have less comorbidities. © 2011 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/76246
ISSN
2013 Impact Factor: 2.225
2013 SCImago Journal Rankings: 1.003
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, HHen_HK
dc.contributor.authorCheung, CWen_HK
dc.contributor.authorJim, MHen_HK
dc.contributor.authorMiu, KMen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorLam, YMen_HK
dc.contributor.authorChan, HWen_HK
dc.contributor.authorLee, WLen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2010-09-06T07:19:11Z-
dc.date.available2010-09-06T07:19:11Z-
dc.date.issued2011en_HK
dc.identifier.citationClinical Cardiology, 2011, v. 34 n. 3, p. E1-E5en_HK
dc.identifier.issn0160-9289en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76246-
dc.description.abstractBackground: The purpose of this study was to describe the clinical characteristics and clinical outcomes for Chinese patients with type A intramural hematoma (IMH). Methods and Results: We studied 90 patients with Stanford type A acute aortic syndrome who presented to our institution from 1998 to 2005 and evaluated the presentation, management, and clinical outcomes of acute IMH by comparing these patients with those diagnosed with classical aortic dissection (AD). A total of 34 patients had IMH and they tended to be older (69.7±12.4 versus 60.5±16.2 years; p = 0.006). The development of pericardial effusion was more frequent in patients with IMH than in patients with AD. They were also less likely to receive surgery as compared to AD patients (26.5% versus 73.2%; p<0.0001). Overall mortality of IMH was not significantly higher than that of classic AD (29.4% versus 21.4%; p = 0.45). For IMH patients, the mortality rate with medical treatment was 32%. Ten (40%) of the 25 medically treated patients developed adverse outcomes. However, no independent predictors of adverse outcomes were identified in the study. In follow-up imaging studies of 15 patients who survived IMH without surgical repair, 14 patients showed complete resolution of IMH and 1 progressed into classical AD. Conclusion: Acute type A IMH in Chinese patients showed a high mortality rate with medical treatment. It has a highly unpredictable course with no reliable clinical and anatomical predictors. Surgical therapy should be the treatment of choice for Chinese patients with acute IMH, especially those who are younger and have less comorbidities. © 2011 Wiley Periodicals, Inc.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.orgen_HK
dc.relation.ispartofClinical Cardiologyen_HK
dc.rightsClinical Cardiology (Hoboken). Copyright © John Wiley & Sons, Inc..-
dc.subjectAortaen_HK
dc.subjectHematomaen_HK
dc.subjectMedical therapyen_HK
dc.subjectMortalityen_HK
dc.subjectSurgeryen_HK
dc.subject.meshAneurysm, Dissecting - diagnosis - mortality - surgery-
dc.subject.meshAortic Aneurysm - diagnosis - mortality - surgery-
dc.subject.meshAortic Diseases - diagnosis - mortality - surgery-
dc.subject.meshAsian Continental Ancestry Group-
dc.subject.meshHematoma - diagnosis - mortality - surgery-
dc.titleType A aortic intramural hematoma: Clinical features and outcomes in Chinese patientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0160-9289&volume=34&issue=3&spage=E1&epage=E5&date=2011&atitle=Type+A+aortic+intramural+hematoma:+clinical+features+and+outcomes+in+Chinese+patientsen_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/clc.20481en_HK
dc.identifier.pmid21400537en_HK
dc.identifier.scopuseid_2-s2.0-79952717459en_HK
dc.identifier.hkuros169695en_HK
dc.identifier.hkuros158930-
dc.identifier.hkuros225171-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79952717459&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue3en_HK
dc.identifier.spageE1en_HK
dc.identifier.epageE5en_HK
dc.identifier.isiWOS:000288816800003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHo, HH=35209997400en_HK
dc.identifier.scopusauthoridCheung, CW=45760893700en_HK
dc.identifier.scopusauthoridJim, MH=6603860344en_HK
dc.identifier.scopusauthoridMiu, KM=16230630500en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridLam, YM=35316083700en_HK
dc.identifier.scopusauthoridChan, HW=7403402419en_HK
dc.identifier.scopusauthoridLee, WL=16230746200en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK

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