EP39 TYPE A INTRAMURAL HEMATOMA AND PENETRATING ATHEROSCLEROTIC ULCERS OF AORTA: EVALUATION AND MANAGEMENT

Abstract

Background and Aims: The aim of our study is to report our experience on the surgical treatment of intramural aortic hematoma (IMH) and penetrating atherosclerotic ulcers (PAU), as less common variants of “acute aortic syndromes”. Methods: From 2010 to 2015, 38 patients with a diagnosis of “acute aortic syndrome” underwent emergency surgery at our Center, of which 31 patients (81.57%), suffering from acute aortic dissection type A, 7 patients (18.42%), affected by IMH and a patient (2.63%) affected by IMH + PAU: All the patients affected by IMH and IMH + PAU underwent emergency surgery. We analyzed the following parameters: General and hemodynamic clinical conditions; Presence of spontaneous breath or endotracheal intubation; Neurological conditions; Timing from diagnosis to surgical treatment; Intervention type performed; Time to wake up. Results: Survival at 30 days was 100%: 6 patients were discharged at home, about 3 weeks after surgery and 2 patients were transferred to Cardiorespiratory Rehabilitation Centers about 3 weeks after surgery, in satisfactory general clinical conditions. Conclusions: Preoperative conditions of the patients, early diagnosis and the timeliness of the surgical treatment represent, in our experience, determinant factors about clinical outcomes.