Surgical versus conservative treatment for acute type A aortic intramural hematoma: A retrospective cohort study
- VernacularTitle:内科与外科治疗急性 A 型主动脉壁间血肿的回顾性队列研究
- Author:
Jue YANG
1
;
Changjiang YU
1
;
Xin LI
1
;
Zerui CHEN
1
;
Fei XIAO
1
;
Tucheng SUN
1
;
Ruixin FAN
1
Author Information
1. Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510080, P. R. China
- Publication Type:Journal Article
- Keywords:
Aortic intramural hematoma;
therapeutic strategy;
surgical treatment;
conservative treatment
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(05):718-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the outcomes following emergency surgery or conservative treatment for patients with acute type A aortic intramural hematoma (IMH). Methods Clinical data of consecutive patients diagnosed with acute type A aortic IMH in our hospital from September 2014 to December 2018 were retrospectively analyzed. The patients who met our surgical indications received surgery (an operation group) and other patients received strict conservative treatment (a conservative treatment group). Results Finally 127 patients were enrolled, including 112 males and 15 females with an average age of 53.6±13.0 years. Of 127 patients, 85 (66.9%) patients accepted emergency surgery and 42 (33.1%) patients accepted strict conservative treatment. There was no difference between the two groups in early mortality or complications (P>0.05). The 5-year survival rate was 90.4% in the operation group and 74.3% in the conservative treatment group (P=0.010). A maximum aortic diameter in the ascending aorta and aortic arch≥45 mm and maximum thickness of IMH in the same section≥8 mm were risk factors for IMH-related death in patients undergoing conservative treatment (P<0.001). Conclusion The mortality associated with emergency surgery for patients with acute type A aortic IMH is satisfactory. In clinical centers with well-established surgical techniques and postoperative management, emergency surgical treatment may provide a better outcome than conservative treatment for patients with acute type A aortic IMH.
