Management of diabetic patients with aortic intramural hematoma: There may be more involved besides MMP9 [post]

Arminder Jasser, Gus Vlahakes
2020 unpublished
This Editorial Comment explores important issues raised by this manuscript. Is intramural hematoma, in fact, an aortic dissection where the intimal tear is not visualized by the current imaging technology? There is certainly a divide between the east and the west regarding the appropriate management strategy for intramural hematoma involving the ascending aorta (IMHA). In the United states, an IMHA is mostly treated like a Type A dissection, with urgent surgery. However, several reports from
more » ... an centers, such as the current series, propose an initial medical approach constituting impulse control and serial imaging to select patients for surgical treatment. These reports have enhanced our understanding of high risk features surrounding IMH (pericardial effusion, aortic diameter > 5 cm, or IMH width > 1 cm) that will likely fail medical management and require surgery.
doi:10.22541/au.159188565.57918944 fatcat:ltscndvemre2fehnc7ejf5jkye