CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1648753
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 17 articles
Successful Conservative Treatment of Type A Aortic Intramural Hematoma with Typical CT Evolution: A Case Report
Provisionally accepted
- Guangdong Provincial People's Hospital, Guangzhou, China
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Type A aortic intramural hematoma (IMH) is a variant of acute aortic syndrome, with emergency surgery traditionally considered the treatment of choice. We report a case of a 69-year-old male patient who presented with chest pain. Computed tomography angiography (CTA) revealed type A aortic intramural hematoma. Given the absence of high-risk progression factors, conservative management with close surveillance was selected. During treatment, periaortic hematoma developed in the descending aorta, but the patient's symptoms significantly improved. Follow-up CTA at 3 months demonstrated complete resolution of the intramural hematoma, and the patient remained in good condition at 2.5 years of follow-up. This case demonstrates that conservative treatment may be a viable option for highly selected type A IMH patients without high-risk progression factors, but should only be considered with rigorous patient selection criteria and intensive monitoring protocols in experienced centers.
Keywords: Acute Aortic Syndrome, Aortic intramural hematoma, conservative treatment, case report, Aorta, Ascending aorta
Received: 17 Jun 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Wu, Song and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinlin Wu, wujinlin_fuwai@126.com
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