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Clinical characteristics and outcomes in patients with acute type A aortic intramural hematoma.
Kanagami, Teruaki; Saito, Yuichi; Hashimoto, Osamu; Nakayama, Takashi; Okino, Shinichi; Sakai, Yoshiaki; Nakamura, Yoshitake; Fukuzawa, Shigeru; Himi, Toshiharu; Kobayashi, Yoshio.
Afiliación
  • Kanagami T; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; Department of Cardiology, Chiba Rosai Hospital, Chiba, Japan.
  • Saito Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. Electronic address: saitoyuichi1984@gmail.com.
  • Hashimoto O; Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan.
  • Nakayama T; Department of Cardiovascular Medicine, International University of Health and Welfare, Narita, Japan.
  • Okino S; Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan.
  • Sakai Y; Department of Cardiology, Chiba Emergency Medical Center, Chiba, Japan.
  • Nakamura Y; Division of Cardiology, Chiba Cerebral and Cardiovascular Center, Ichihara, Japan.
  • Fukuzawa S; Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan.
  • Himi T; Division of Cardiology, Kimitsu Central Hospital, Kisarazu, Japan.
  • Kobayashi Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Int J Cardiol ; 391: 131355, 2023 11 15.
Article en En | MEDLINE | ID: mdl-37696364
BACKGROUND: Although type A acute aortic dissection (AAD) including classic double-channel aorta and intramural hematoma (IMH) is a life-threatening condition, the prognostic impact and predictors of IMH remain to be established. The present study evaluated the prevalence, baseline characteristics, and outcomes of IMH as compared with classic non-thrombosed type A AAD. METHODS: This multicenter registry in Japan retrospectively included 703 patients with type A AAD. IMH was defined as a crescentic or circular area along the ascending aortic wall without contrast enhancement on computed tomography (CT). Non-thrombosed type A AAD was defined as the classic double-channel ascending aorta on contrast-enhanced CT. The primary endpoint was in-hospital mortality. RESULTS: Of the 703 patients with type A AAD, 312 (44.3%) had IMH. Older age was an only baseline patient factor significantly associated with the presence of IMH in the multivariable analysis. The longitudinal extent of dissection was greater in patients with classic non-thrombosed AAD than those with IMH, resulting in an increased risk of end-organ malperfusion in the classic AAD group. During the hospitalization, 41 (13.1%) and 85 (21.7%) patients with and without IMH died (p < 0.001). IMH was associated with lower in-hospital mortality in a multivariable model, irrespective of age and the implementation of surgery. CONCLUSIONS: The present study showed that IMH on CT was frequent among patients with type A AAD. Although IMH was more likely to be present in the elderly, its effect on the better survival was independent of age and surgical treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Aorta / Disección Aórtica Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Int J Cardiol Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Aorta / Disección Aórtica Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: Int J Cardiol Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos