title: Clinical features and long-term outcome of type A and type B intramural hematoma of the aorta.
abstract: OBJECTIVE
  Most previous reports on intramural hematoma of the aorta have focused on the initial episode. The purpose of this study was to clarify the long-term outcome of intramural hematoma of the aorta.
  
  
  METHODS
  Ninety-four cases of intramural hematoma of the aorta (41 type A and 53 type B) were reviewed. There were 69 male and 25 female patients, and their mean age was 66.7 +/- 8.7 years (range, 46-88 years).
  
  
  RESULTS
  Eleven (27%) of the patients with type A hematoma and 1 (2%) of the patients with type B hematoma underwent early surgical intervention. Others were treated medically, and the overall hospital mortality was 7% for patients with type versus 2% for patients with type B intramural hematomas of the aorta (P =.315). Twenty-three patients, 9 (22%) with type A and 14 (26%) with type B intramural hematomas of the aorta, underwent late surgical intervention during the follow-up period, and there were no hospital deaths. A total of 23 patients died during the follow-up period, including 6 of intramural hematoma of the aorta-related deaths (3 in the type A group and 3 in the type B group). The estimated freedom from intramural hematoma of the aorta-related events at 1 and 5 years was 70% +/- 8% and 54% +/- 11% for the type A group versus 73% +/- 6% and 58% +/- 8% for the type B group, respectively (P =.972). After excluding the nonintramural hematoma of the aorta-related deaths, the survival rates at 5 and 10 years were 80% +/- 9% and 80% +/- 9% for the type A group and 91% +/- 8% and 81% +/- 11% for the type B group (P =.211).
  
  
  CONCLUSIONS
  Intramural hematoma of the aorta-related events occur equally in both types of intramural hematoma of the aorta. We recommend close follow-up for at least 5 years because most intramural hematoma of the aorta-related events occur during this period.
authors.affiliation: Division of Cardiovascular Surgery, Sendai City Medical Center, Miyagiken, Japan. moizumi@openhp.or.jp
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Moizumi
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Komatsu
authors.forename: Naotaka
authors.initials: N
authors.lastname: Motoyoshi
authors.forename: Koichi
authors.initials: K
authors.lastname: Tabayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D001019:Aortic Rupture / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D006348:Cardiac Surgical Procedures; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D016019:Survival Analysis; D013995:Time; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome