Aortic & peripheral vascular diseaseMeta-analysis
Clinical characteristics and outcomes of type A intramural haematoma and aortic dissection: a systematic review and meta-analysis of 6457 patients
- systematic review and meta-analysis
- random-effects models
- Hartung-Knapp-Sidik-Jonkman corrections for small samples
Authors' conclusion
TAIMH differs pathophysiologically and prognostically from classical TAAD, demonstrating lower perioperative mortality despite affecting an older population. These findings support distinct risk stratification and tailored surgical strategies for TAIMH and should inform updates to future aortic-disease guidelines.
Study context
- Population
- Patients with type A intramural haematoma (TAIMH) or type A aortic dissection (TAAD)TAIMH 1,288 · TAAD 5,169
- Participants
- 6,457 patients · 16 studies
- Comparison
- TAIMH vs TAAD
- TAIMHn = 1,288
- TAADn = 5,169reference
- Outcome
- In-hospital mortality
Pooled result
As reported in the abstract
Relative risk
0.49
95% CI 0.35–0.68
TAIMH vs TAAD
RR 0.49 (95% CI 0.35–0.68)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| 30-day mortality | 0.59 (0.40–0.88) | |
| Operative mortality | 0.31 (0.16–0.60) | |
| 0.10.31310Relative risk (log scale) |
Patient characteristics
- Compared with TAAD, patients with TAIMH were older, more often female and had more hypertension but less connective-tissue disease, severe aortic regurgitation and malperfusion
Operative findings
- TAIMH was associated with shorter aortic cross-clamp and cardiopulmonary bypass times and fewer total arch replacements
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Postoperative acute kidney injury · consistent across eastern and western populations | 0.57 (0.42–0.76) | |
| 0.512Relative risk (log scale) |
Original publication
Clinical characteristics and outcomes of type A intramural haematoma and aortic dissection: a systematic review and meta-analysis of 6457 patients. Heart. Published 12 January 2026. doi:10.1136/heartjnl-2025-326602
Summarised from the published abstract; every number is checked against it