naa a22 4500 51072874X CHVBK 20180411082945.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s11748-012-0194-0 doi (NATIONALLICENCE)springer-10.1007/s11748-012-0194-0 A treatment strategy for early thrombosed Stanford type A acute aortic dissection [Elektronische Daten] [Takeshi Uzuka, Toshiro Ito, Takayuki Hagiwara, Yohsuke Yanase, Tetsuya Koyanagi, Yoshihiko Kurimoto, Nobuyoshi Kawaharada, Tetsuya Higami] Objective: Early thrombosed aortic dissection is a form of aortic dissection and includes the condition called aortic intramural hematoma. It was generally considered as surgical emergency. However, the optimal treatment strategy for acute type A intramural hematoma is becoming controversial after recent studies indicated more benign clinical course for this disease. We evaluated our strategy that integrated medical therapy, serial imaging, and timed surgery. Methods: We reviewed 34 consecutive patients who were admitted to our hospital for early thrombosed Stanford type A acute aortic dissection from 2006 to 2011. Medical therapy or timed surgery was offered on the basis of radiological findings. Emergency or urgent surgery was not considered for a hemodynamically stable patient unless the ascending aortic diameter was ≧50mm or the thickness of the thrombosed false lumen was ≧10mm. Follow-up computed tomography was performed to detect a potential progression to aortic dissection. Results: During the average follow-up period of 24.3months, there was no aortic dissection-related mortality. And aortic dissection-related event was not recorded in patients who had surgical repair; however, in patients who did not have surgery, 3 (8.8%) surgical conversions were recorded due to aortic dissection progression during the follow-up period. Twenty-one patients (61.8%) ultimately had surgical repair, and 13 patients (38.2%) had complete medical therapy. The overall survival rate at 3years was 86.5%. Conclusions: Our strategy for the treatment of early thrombosed Stanford type A acute aortic dissection is reasonable, and the mid-term results were acceptable. The Japanese Association for Thoracic Surgery, 2012 Early thrombosed Stanford type A acute aortic dissection nationallicence Stanford type A acute aortic dissection nationallicence Stanford type A intramural hematoma nationallicence Uzuka Takeshi Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Ito Toshiro Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Hagiwara Takayuki Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Yanase Yohsuke Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Koyanagi Tetsuya Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Kurimoto Yoshihiko Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Kawaharada Nobuyoshi Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut Higami Tetsuya Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/2(2013-02-01), 84-88 1863-6705 61:2<84 2013 61 11748 https://doi.org/10.1007/s11748-012-0194-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0194-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Uzuka Takeshi Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Ito Toshiro Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Hagiwara Takayuki Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Yanase Yohsuke Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Koyanagi Tetsuya Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kurimoto Yoshihiko Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kawaharada Nobuyoshi Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 700 1- Higami Tetsuya Thoracic and Cardiovascular Surgery, Sapporo Medical University, S1W16 Chuo-ku Sapporo, 060-8543, Hokkaido, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/2(2013-02-01), 84-88 1863-6705 61:2<84 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer