Repair of intramural hematoma of the ascending aorta without graft interposition.

A 68-year-old woman was admitted to hospital with a one-hour history of chest pain and syncopal episode. Transesophageal echocardiography showed an intramural aortic hematoma with cardiac tamponade. The patient underwent repair of the ascending aorta without graft interposition (resection and end-to-end anastomosis). The patient had an uneventful postoperative course and the 38-month follow-up was event-free. This case report shows that end-to-end anastomosis in patients with intramural hematoma and absence of intimal tearing, may provide good long-term results.