CT angiography manifestations and prognosis of acute Standford type A aortic dissection complicated with pulmonary artery intramural hematoma
Objective To investigate CT angiography(CTA)manifestations of acute Standford type A aortic dissection(AD)complicated with pulmonary artery intramural hematoma(PAIH),and to explore correlations with prognosis.Methods Data of 55 patients with acute Standford type A AD complicated with PAIH(PAIH group),as well as 55 acute Standford type A AD patients without PAIH(control group)were retrospectively analyzed.Aortal and coronary CTA manifestations groups were compared between groups,and hematoma absorption in PAIH group 15 days after treatment was observed.Aortic adverse events were also compared between groups within 1 year after discharge,and the patients were divided into those with good prognosis or with poor prognosis,the impact factors of prognosis were screened.Results The maximum width of ascending aorta in PAIH group was larger than that in control group([5.22±0.57]cm vs.[4.54±0.45]cm,t=6.963,P＜0.001).PAIH was likely to involve aortic valve,sinus canal junction,right and noncoronary sinus and right coronary artery,and patients in PAIH group were likely to occur pericardial and pleural effusion(all P＜0.05).In PAIH group,42 cases received surgical treatment,13 cases did not receive surgical treatment for critical condition and then died.Fifteen days after surgery,36 of 42 cases had reduced scope of hematoma.Totally 103 cases were followed up,63 were found with good prognosis while and 40 with poor prognosis.Age and complicated with PAIH were both independent predictors of poor prognosis in acute Standford type A AD patients(OR=1.07,4.71).Conclusion CTA manifestations of acute Standford type A AD complicated with PAIH had certain characteristics,which might be helpful for predicting prognosis.
dissection of aortapulmonary arteryhematomacomputed tomography angiography
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