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Large Intramural Aortic Hematoma with Intimal Tear.
Frédéric Jacques1, Michel Gingras2, Valérie Lafrenière-Bessi1
1Departments of Cardiac Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec-IUCPQ, Quebec, QC, Canada.
Aorta (Stamford, Conn.)
|November 9, 2020
Summary
A patient experienced severe epigastric pain due to an aortic intramural hematoma. Surgical repair of the ascending aorta was successfully performed using deep hypothermic circulatory arrest.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Aortic intramural hematoma (IMH) is a variant of aortic dissection.
- IMH can present with severe chest or back pain, mimicking other acute aortic syndromes.
- Early diagnosis and appropriate management are crucial for favorable outcomes.
Purpose of the Study:
- To report a case of aortic intramural hematoma presenting with epigastric pain.
- To describe the diagnostic findings, including computed tomography angiography (CTA).
- To detail the surgical management of ascending aortic replacement under deep hypothermic circulatory arrest.
Main Methods:
- Case presentation of a 72-year-old male with acute epigastric pain.
- Diagnostic imaging utilizing chest computed tomography angiography (CTA).
- Surgical intervention involving ascending aortic replacement with deep hypothermic circulatory arrest.
Main Results:
- CTA revealed an aortic intramural hematoma and a filling defect in the distal ascending aorta.
- The patient underwent successful ascending aortic replacement.
- The surgical procedure was performed under deep hypothermic circulatory arrest.
Conclusions:
- Aortic intramural hematoma can present atypically with epigastric pain.
- CTA is effective in diagnosing aortic intramural hematoma.
- Surgical repair with deep hypothermic circulatory arrest is a viable treatment option for complex ascending aortic pathologies.
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