[HSF] intramural hematoma

[jbflegejr at aol.com]

Giulio, I had an identical case a couple of years ago and did resection 
of the ascending aorta just like for Type A dissection. Afterwards I 
questioned my decision. The object of treating Type A dissection is to 
remove the part of the aorta which has the intimal tear. In intramural 
hematoma there is no intimal tear. Is it logical to resect part of the 
aorta in absence of intimal tear or even a penetrating ulcer? John Flege

-----Original Message-----
From: giulio.rizzoli at unipd.it
To: OpenHeart-L at lists.hsforum.com
Sent: Wed, 4 Oct 2006 4:50 AM
Subject: [HSF] intramural hematoma

    For those who doubt that an intramural hematoma is alike aortic 
dissection 
  I want to show the images of the last case (78 y/o) I operated on with 
a modified Bentall. 
 27° , axillary artery and left carotid perfusion trough exposed arch. 
  There was no trace of dissection at angio but a very thickened aortic 
wall at CT scan. 
  I show the appearance at pericardiectomy, identical to that of a 
dissection and the clots sandwich between media and adventitia. 
   Giulio Rizzoli, Padova Italy 

   Giulio Rizzoli MD FETCS 
 Cardiochirurgia Padova 
 tel. 049 821-2408 
 fax 049 821-2409 
 e-mail giulio.rizzoli at unipd.it 

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