Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma

  • Received : 2015.07.20
  • Accepted : 2015.10.22
  • Published : 2016.04.05
Download PDF
⟨ Previous Next ⟩

Abstract

We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively.

Keywords

References

  1. Von Kodolitsch Y, Csosz SK, Koschyk DH, et al. Intramural hematoma of the aorta: predictors of progression to dissection and rupture. Circulation 2003;107:1158-63. https://doi.org/10.1161/01.CIR.0000052628.77047.EA
  2. Evangelista A, Dominguez R, Sebastia C, et al. Long-term follow-up of aortic intramural hematoma: predictors of outcome. Circulation 2003;108:583-9. https://doi.org/10.1161/01.CIR.0000081776.49923.5A
  3. Nishigami K, Tsuchiya T, Shono H, Horibata Y, Honda T. Disappearance of aortic intramural hematoma and its significance to the prognosis. Circulation 2000;102(19 Suppl 3):III243-7.
  4. Mohr-Kahaly S. Aortic intramural hematoma: from observation to therapeutic strategies. J Am Coll Cardiol 2001;37:1611-3. https://doi.org/10.1016/S0735-1097(01)01189-5
  5. Song JK, Yim JH, Ahn JM, et al. Outcomes of patients with acute type A aortic intramural hematoma. Circulation 2009;120:2046-52. https://doi.org/10.1161/CIRCULATIONAHA.109.879783
  6. Evangelista A, Mukherjee D, Mehta RH, et al. Acute intramural hematoma of the aorta: a mystery in evolution. Circulation 2005;111:1063-70. https://doi.org/10.1161/01.CIR.0000156444.26393.80
  7. Ohmi M, Tabayashi K, Moizumi Y, Komatsu T, Sekino Y, Goko C. Extremely rapid regression of aortic intramural hematoma. J Thorac Cardiovasc Surg 1999;118:968-9. https://doi.org/10.1016/S0022-5223(99)70075-9
  8. Park KH. Prevalence of intimal defect in the patients with surgically treated acute type A intramural hematoma of the aorta. Korean J Thorac Cardiovasc Surg 2007;40:733-44.