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, HW
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
2011 Impact Factor: 2.151
2011 SCImago Journal Rankings: 0.110
DOIhttp://dx.doi.org/10.1002/clc.20481
ISI Accession Number IDWOS:000288816800003
ReferencesReferences in Scopus
DC Field
Value
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_subscribed_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.isiWOS:000288816800003
dc.identifier.issn0160-9289
2011 Impact Factor: 2.151
2011 SCImago Journal Rankings: 0.110
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
Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong