Key result
Surgical graft replacement successfully manages delayed Stanford type A intramural hematoma progressing to aortic dissection.
Why the study?
Diagnosis of intramural hematoma can be delayed and challenging due to atypical presentation, investigation findings, and case progression.
Case Report (n=1)
No
This case report highlights the diagnostic challenges of intramural hematoma and demonstrates that surgical management can lead to good outcomes even when diagnosis is delayed.
Diagnostic delays in type A intramural hematoma warrant vigilance; this single case leaves open optimal detection and intervention thresholds.
Intramural hematoma (IMH) is considered a part of acute aortic syndromes (AAS), a group of life-threatening aortic diseases with a similar presentation that appears to have different clinical manifestations and pathological and survival characteristics. AAS comprises three major entities, namely, aortic dissection (AD), IMH, and PAU. IMH-like classic AD is classified using Stanford and DeBakey classification systems to indicate the aortic area involved. Early diagnosis and treatment of AAS are crucial for survival; however, diagnosis of IMH may be delayed and challenging due to atypical presentation, investigation findings, and case progression. In this report, we describe a case of delayed and challenging diagnosis of a Stanford type A IMH that was managed surgically with a good outcome.
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Kanaan et al. (2023) conducted a case report in Type A Aortic Dissection with Intramural Hematoma (n=1). Surgical aortic repair was evaluated on Clinical outcome. A 47-year-old male with a delayed diagnosis of Stanford type A intramural hematoma progressing to classic aortic dissection was successfully managed with surgical excision and interposition graft replacement.
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