A Surgical Case of Aortic Intramural Hematoma in the Presence of Coexisting Ascending Aortic Aneurysm

(Department of Cardiovascular Surgery, Otaru Municipal Second Hospital, Otaru, Japan)

Yukihiko Tamiya Johji Fukada Yasuaki Fuzisawa
An 82-year-old woman was given emergency admission because of severe anterior chest pain. We found an ascending aortic aneurysm 60mm in diameter. CT revealed acute aortic dissection with an ascending aorta. Emergeny operation was performed under a diagnosis of type-A acute aortic dissection with ascending aortic aneurysm. Operative findings showed thrombus in the dissection and a dilated ascending aorta without intimal tears. Operative findings differed from those of a classical dissection and were compatible with a diagnosis of aortic intramural hematoma (IMH). We performed hemi-arch replacement for the ascending aortic aneurysm under deep hypothermic cardiac arrest and she was discharged without any complications. IMH in the presence of coexisting ascending aortic aneurysm is extremely rare and we therefore reported the surgical repair of this rare case.
@Jpn. J. Cardiovasc. Surg. 37: 295-297 (2008)