title: Intramural hematoma of the aorta: diagnosis and treatment.
abstract: OBJECTIVE
  Increasing use of modern high-resolution imaging techniques yields to describe very early stages of aortic pathology which, if left untreated, may lead to overt aortic dissection. One typical example is aortic intramural hematoma (IMH) with a limited number of cases described in the literature and uncertainties still existing about the most appropriate treatment. Purpose of our study is to report our experience in the evaluation and treatment of IMHs.
  
  
  METHODS
  From 1991 to 1999 175 patients were conveyed to our centre for aortic dissection; in nine of them diagnosis of acute IMH was performed.
  
  
  RESULTS
  Diagnosis was obtained by means of conventional CT scan of the chest. All the patients underwent surgery, one patient died (11%). At the follow-up (mean 31 months) eight patients were alive and well and did not require any other cardiac surgery.
  
  
  CONCLUSIONS
  The possibility to progress to overt aortic dissection may explain the need to an early diagnosis in the treatment of acute IMHs. Immediate surgical treatment is, in our experience, the preferred therapeutic option.
authors.affiliation: Department of Cardio-thoracic Surgery, V.le Morgagni 85, 50134 Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vaccari
authors.forename: S
authors.initials: S
authors.lastname: Caciolli
authors.forename: G
authors.initials: G
authors.lastname: Calamai
authors.forename: M
authors.initials: M
authors.lastname: Acquafresca
authors.forename: G
authors.initials: G
authors.lastname: Montesi
authors.forename: L
authors.initials: L
authors.lastname: Braconi
authors.forename: M
authors.initials: M
authors.lastname: Cassai
authors.forename: A M
authors.initials: AM
authors.lastname: Perna
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000628:therapy*