CC BY 4.0 · Aorta (Stamford) 2021; 09(04): 155-157
DOI: 10.1055/s-0041-1729849
Case Report

Complicated Intramural Hematoma with Medionecrosis of the Aortic Wall

1   Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
Natalie Gaughan
2   Florida Atlantic University, Boca Raton, Florida
Daniel Anderson
3   Division of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
4   Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, Maryland
› Author Affiliations
Funding None.


Medionecrosis and medial degeneration are rare complications associated with intramural hematomas (IMHs). We present a case of a 69-year-old Asian female with an IMH with medionecrosis and medial degeneration of the aortic wall. The patient underwent successful surgical intervention, and pathological findings were significant for cystic medial degeneration of the aortic wall.

Publication History

Received: 27 March 2020

Accepted: 25 February 2021

Article published online:
29 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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  • References

  • 1 Mussa FF, Horton JD, Moridzadeh R, Nicholson J, Trimarchi S, Eagle KA. Acute aortic dissection and intramural hematoma: a systematic review. JAMA 2016; 316 (07) 754-763
  • 2 Bossone E, LaBounty TM, Eagle KA. Acute aortic syndromes: diagnosis and management, an update. Eur Heart J 2018; 39 (09) 739-749d
  • 3 Evangelista A, Dominguez R, Sebastia C. et al. Prognostic value of clinical and morphologic findings in short-term evolution of aortic intramural haematoma. Therapeutic implications. Eur Heart J 2004; 25 (01) 81-87
  • 4 Tsai TT, Nienaber CA, Eagle KA. Acute aortic syndromes. Circulation 2005; 112 (24) 3802-3813
  • 5 Harris KM, Braverman AC, Eagle KA. et al. Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation 2012; 126 (11, Suppl 1): S91-S96
  • 6 Halushka MK, Angelini A, Bartoloni G. et al. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria. Cardiovasc Pathol 2016; 25 (03) 247-257
  • 7 Erbel R, Aboyans V, Boileau C. et al; ESC Committee for Practice Guidelines, The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J 2014; 35 (41) 2873-2926