BACKGROUND: Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. METHODS: All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). RESULTS: IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). CONCLUSION: There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea.
BACKGROUND: Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. METHODS: All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). RESULTS: IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). CONCLUSION: There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea.
Authors: Foeke Nauta; Hector de Beaufort; Firas F Mussa; Carlo De Vincentiis; Atsushi Omura; Hitoshi Matsuda; Santi Trimarchi Journal: Ann Cardiothorac Surg Date: 2019-09
Authors: William C Frankel; Scott A Weldon; Susan Y Green; Hiruni S Amarasekara; Scott A LeMaire; Joseph S Coselli Journal: Tex Heart Inst J Date: 2020-08-01
Authors: Orla Buckley; Frank J Rybicki; David S Gerson; Colleen Huether; Richard F Prior; Sara L Powers; Hale Ersoy Journal: Int J Cardiovasc Imaging Date: 2009-09-24 Impact factor: 2.357
Authors: Harleen K Sandhu; Akiko Tanaka; Kristofer M Charlton-Ouw; Rana O Afifi; Charles C Miller; Hazim J Safi; Anthony L Estrera Journal: Ann Cardiothorac Surg Date: 2016-07