Abstract 4142523: Factors Associated With Pericardial Effusion and Outcomes of Conservative Versus Surgical Treatment in Cases of Acute Type A Intramural Hematoma

• DOI: 10.1161/circ.150.suppl_1.4142523
• Publication Date: 2024-11-14T09:02:39Z
• Authors: Minoru Kowada; Daijiro Hori; Ryotaro Yamada; Hidetaka Kariya; Kento Fujii; Takehiro Shirasugi; Mitsunori Nakano; Manabu Shiraishi; Homare Okamura; Hideki Morita; Atsushi Yamaguchi; Naoyuki Kimura
• Keywords: Conservative Treatment

Background: Patients with aortic intramural hematoma (IMH) often present cardiac tamponade. However, factors associated the precipitating pericardial effusion remain to be elucidated. Hypothesis: Morphologic affect IMH-associated effusion. Aims: To identify and compare outcomes of conservative therapy vs urgent surgery in acute type A IMH. Methods: Included study were 195 patients hospitalized for IMH within 48 hours onset. They identified from among 803 consecutive syndrome treated at 2 centers between 2009 2022, 213 (27%) having Study 1: Per on-admission CT data, correlation maximum width ascending diameter or thickness was assessed. Factors massive (>12.6 mm, upper quartile) tamponade (systolic blood pressure <80 mmHg effusion, n=49) assessed by multivariable analysis. 2: Outcomes compared who underwent (n=57) those (n=138). Conservative principally performed if certain conditions met: <50 <11 absence Results: Pericardial found correlate (r=0.268, p<0.001) but not (r=-0.053, p=0.46). Association dissection extending abdominal aorta (p=0.010, OR=0.41) (p=0.048, OR=1.053). Median age (73 vs. 73.5 years, p=0.74), sex, comorbidities similar group group. Five (9%) expansion 30 days onset, no hospital death resulting. Thirty-day mortality (10.5% 5.8%, p=0.25) 5-year survival (81.1% 84.2%, p=0.33) did differ. event (surgery, redissection, sudden death) rate increased (27.3% 12.6%, p=0.003). Conclusions: Extent are Aortic events likelihood therapy.