[HSF] intramural hematoma

[prasannasimha]

There is evidence that an intramural hematoma is the early stage of a 
dissection. I will try to dig out that data. This hematoma then bursts 
inside and starts a dissection.
Prasanna

jbflegejr at aol.com wrote:
> 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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