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Article: Type A aortic intramural hematoma: Clinical features and outcomes in Chinese patients
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TitleType A aortic intramural hematoma: Clinical features and outcomes in Chinese patients
 
AuthorsHo, HH1
Cheung, CW2
Jim, MH1
Miu, KM1
Siu, CW1
Lam, YM1
Chan, HW1
Lee, WL1
Tse, HF1
 
KeywordsAorta
Hematoma
Medical therapy
Mortality
Surgery
 
Issue Date2011
 
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
 
CitationClinical Cardiology, 2011, v. 34 n. 3, p. E1-E5 [How to Cite?]
DOI: http://dx.doi.org/10.1002/clc.20481
 
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.
 
ISSN0160-9289
2012 Impact Factor: 1.834
2012 SCImago Journal Rankings: 0.588
 
DOIhttp://dx.doi.org/10.1002/clc.20481
 
ISI Accession Number IDWOS:000288816800003
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorHo, HH
 
dc.contributor.authorCheung, CW
 
dc.contributor.authorJim, MH
 
dc.contributor.authorMiu, KM
 
dc.contributor.authorSiu, CW
 
dc.contributor.authorLam, YM
 
dc.contributor.authorChan, HW
 
dc.contributor.authorLee, WL
 
dc.contributor.authorTse, HF
 
dc.date.accessioned2010-09-06T07:19:11Z
 
dc.date.available2010-09-06T07:19:11Z
 
dc.date.issued2011
 
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.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationClinical Cardiology, 2011, v. 34 n. 3, p. E1-E5 [How to Cite?]
DOI: http://dx.doi.org/10.1002/clc.20481
 
dc.identifier.doihttp://dx.doi.org/10.1002/clc.20481
 
dc.identifier.epageE5
 
dc.identifier.hkuros169695
 
dc.identifier.hkuros158930
 
dc.identifier.hkuros225171
 
dc.identifier.isiWOS:000288816800003
 
dc.identifier.issn0160-9289
2012 Impact Factor: 1.834
2012 SCImago Journal Rankings: 0.588
 
dc.identifier.issue3
 
dc.identifier.openurl
 
dc.identifier.pmid21400537
 
dc.identifier.scopuseid_2-s2.0-79952717459
 
dc.identifier.spageE1
 
dc.identifier.urihttp://hdl.handle.net/10722/76246
 
dc.identifier.volume34
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.clinicalcardiology.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofClinical Cardiology
 
dc.relation.referencesReferences in Scopus
 
dc.rightsClinical Cardiology (Hoboken). Copyright © John Wiley & Sons, Inc..
 
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.subjectAorta
 
dc.subjectHematoma
 
dc.subjectMedical therapy
 
dc.subjectMortality
 
dc.subjectSurgery
 
dc.titleType A aortic intramural hematoma: Clinical features and outcomes in Chinese patients
 
dc.typeArticle
 
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<contributor.author>Siu, CW</contributor.author>
<contributor.author>Lam, YM</contributor.author>
<contributor.author>Chan, HW</contributor.author>
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<subject>Aorta</subject>
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Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong