Ram Harish, Weaver Andrew R, Dorfling Johannes
From the Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, Kentucky.
A A Pract. 2020 Apr;14(6):e01191. doi: 10.1213/XAA.0000000000001191.
Aortic intramural hematoma (IMH) is a collection of blood within the aortic wall without an identifiable intimal tear. It belongs to the spectrum of acute aortic syndrome (AAS) which also includes aortic dissection (AD), a well-defined entity. Principles of management guided by Stanford classification is similar in both entities. But with recent advances in imaging, certain features of IMH have been identified that affect the natural course of IMH. We report a unique case of iatrogenic IMH complicating a routine coronary artery bypass graft surgery (CABG) and how imaging guided intraoperative decision making toward conservative management.
主动脉壁内血肿（IMH）是指主动脉壁内的血液积聚，而没有可识别的内膜撕裂。它属于急性主动脉综合征（AAS）的范畴，急性主动脉综合征还包括主动脉夹层（AD），这是一个明确的实体。由斯坦福分类法指导的管理原则在这两种情况下相似。但随着影像学的最新进展，已发现IMH的某些特征会影响IMH的自然病程。我们报告了一例因常规冠状动脉搭桥手术（CABG）并发医源性IMH的独特病例，以及影像学如何指导术中决策采取保守治疗。
