title: Management of intramural hematoma of the ascending aorta and aortic arch: the risks of limited surgery.
abstract: We present the case of a 57-year-old woman who had an intramural hematoma of the ascending aorta and aortic arch. After initial blood pressure control and imaging studies, the patient underwent limited surgical repair that consisted of ascending aortic replacement. One week postoperatively, the aortic arch hematoma progressed to a full dissection that extended into the proximal descending aorta. Emergent aortic arch replacement was required. Current world medical literature regarding thoracic aortic intramural hematoma is presented. This case supports the treatment of intramural hematomas of the ascending aorta and arch by surgical replacement of both segments with a Dacron graft, with the patient under deep hypothermic circulatory arrest.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, State University of New York--Downstate Medical Center, Brooklyn, New York 11203-2098, USA.
authors.forename: David V
authors.initials: DV
authors.lastname: Saborio
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadeghi
authors.forename: Joshua H
authors.initials: JH
authors.lastname: Burack
authors.forename: Robert C
authors.initials: RC
authors.lastname: Lowery
authors.forename: Mark H
authors.initials: MH
authors.lastname: Genovesi
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Brevetti
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006406:Hematoma / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012086:Reoperation; D017211:Treatment Failure