Abstract
To the Editor: I read with great interest the article by Evangelista et al1 about intramural hematoma (IMH) of the aorta. The study population comprised a subgroup of 12 patients with IMH of the ascending aorta for whom initial conservative treatment was recommended. This seems somewhat surprising in view of the fact that after a median follow-up of 43 months, 9 patients had undergone surgery, 3 of whom died postoperatively. Of the remaining 3 patients, only 1 survived. This amounts to an actual mortality of 42% (5 out of 12 patients), which is much higher than what could be expected after primary surgery. Even after surgical treatment of an acute ascending …
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