Successful Conservative Treatment of a Type A Aortic Intramural Hematoma

Dimitrios Vlastos; Francisco Fernandes; Ishaansinh Chauhan; Saeed Mirsadraee; George Asimakopoulos

doi:10.1016/j.jaccas.2020.05.051

Successful Conservative Treatment of a Type A Aortic Intramural Hematoma

JACC Case Rep. 2020 Jul 15;2(8):1143-1147. doi: 10.1016/j.jaccas.2020.05.051. eCollection 2020 Jul.

Authors

Dimitrios Vlastos¹, Francisco Fernandes¹, Ishaansinh Chauhan¹, Saeed Mirsadraee¹, George Asimakopoulos¹

Affiliation

¹ Royal Brompton Hospital, London, United Kingdom.

Abstract

Type A intramural hematoma (IMH) constitutes a variant of acute aortic syndrome. Western guidelines support an aggressive surgical approach, whereas Asian centers propose initial conservative treatment. Further expanding on this notion, we present a case of conservative subacute type A IMH management, resulting in radical hematoma resorption within 4 weeks. (Level of Difficulty: Beginner.).

Keywords: AD, aortic dissection; CTA, computational tomography angiography; HTN, hypertension; IMH, intramural hematoma; IRAD, International Registry of Acute Aortic Dissection; MDT, multidisciplinary team; TAA, thoracic aortic aneurysm; anti-impulse treatment; aortic dissection; intramural hematoma.

Publication types

Case Reports