Long-term Follow-up of Aortic Intramural Hematomas and Penetrating Ulcers Alan S. Chou, BA, Bulat A....
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Long-term Follow-up of Aortic Intramural Hematomas and Penetrating Ulcers Alan S. Chou, BA, Bulat A. Ziganshin, MD, Paris Charilaou, MD, Maryann Tranquilli,
Long-term Follow-up of Aortic Intramural Hematomas and
Penetrating Ulcers Alan S. Chou, BA, Bulat A. Ziganshin, MD, Paris
Charilaou, MD, Maryann Tranquilli, RN, John A. Rizzo, PhD, John A.
Elefteriades, MD Aortic Institute at Yale-New Haven Hospital, Yale
University School of Medicine New Haven, Connecticut, USA Presented
at the 95 th Annual Meeting of the American Association of Thoracic
Surgery April 28 th, 2015 1
Slide 2
Disclosures Alan S. Chou, BA: Nothing to disclose. Bulat A.
Ziganshin, MD: Nothing to disclose. Paris Charilaou, MD: Nothing to
disclose. Maryann Tranquilli, RN: Nothing to disclose. John A.
Rizzo, PhD: Nothing to disclose. John A. Elefteriades, MD: DSMB for
Jarvik Heart, Solus Valve; Research Grant Vascutek; Medical
Director for CoolSpine. 2
Aim of the study To evaluate the long-term natural history and
progression of intramural hematomas and penetrating aortic ulcers
including clinical and radiological follow-up and survival
analysis. 7
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Progression of Lesions 8
Slide 9
9 Resolution
Slide 10
Progression of Lesions 10 Resolution No Change (Stable)
Slide 11
Progression of Lesions 11 Resolution No Change (Stable)
Worsening
Patient profile 15 108 consecutive patients (1995-2014) 108
consecutive patients (1995-2014) 55 IMH patients (51%) 55 IMH
patients (51%) 56% Female 53 PAU patients (49%) 53 PAU patients
(49%) 57% Female All patients were symptomatic at presentation All
patients were symptomatic at presentation
Slide 16
Age of IMH and PAU Patients 16 Mean age IMH 70.310 yrs Mean age
PAU 71.410 yrs
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Location Distribution 17
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Intramural Hematoma 18
Slide 19
Hospital Course of IMH 19 55 Patients with IMH 55 Patients with
IMH
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Hospital Course of IMH 20 55 Patients with IMH 55 Patients with
IMH 82% Non-Rupture State (n = 45) 82% Non-Rupture State (n = 45)
18% Rupture State (n = 10) 18% Rupture State (n = 10)
Slide 21
Hospital Course of IMH 21 55 Patients with IMH 55 Patients with
IMH 82% Non-Rupture State (n = 45) 82% Non-Rupture State (n = 45)
18% Rupture State (n = 10) 18% Rupture State (n = 10) Coady MA,
Rizzo JA, Elefteriades JA. Pathologic variants of thoracic aortic
dissections. Penetrating atherosclerotic ulcers and intramural
hematomas. Cardiol Clin 1999;17:637-57. High incidence of rupture
at presentation compared with 8% and 4% for classic Type A and B
dissection previously observed (p