Clinical significance of echo-free space detected by transesophageal echocardiography in patients with type B aortic intramural hematoma

Jong Min Song, Duk Hyun Kang, Jae Kwan Song, Hyun Sook Kim, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park, Tae Hwan Lim

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To evaluate the prevalence and clinical significance of echo-free space (EFS) in aortic intramural hematoma (AIH) during transesophageal echocardiography (TEE), TEE performed during the acute phase in 71 consecutive patients with type B AIH was reviewed. Forty-four patients (62%) had EFS including 24 patients with a large EFS occupying >1/2 of the hematoma thickness. Among 59 patients who also underwent computed tomography, focal contrast enhancement in the hematoma area was observed in only 7 patients with a large EFS. Hospital mortality and incidence of surgical intervention in patients with EFS were 0% and 2%, respectively, which was similar to 4% in those without EFS. Follow-up imaging studies in 57 patients (80%) revealed development of typical aortic dissection (AD) in 6 patients and complete resorption of hematoma in 35; the incidence of either the development of AD or a complete resorption of hematoma was not significantly different between those with and without EFS. EFS by TEE is not rare in patients with type B AIH. It is not a poor prognostic factor and is not associated with the development of AD.

Original languageEnglish
Pages (from-to)548-551
Number of pages4
JournalAmerican Journal of Cardiology
Issue number5
Publication statusPublished - 2002 Mar 1


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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