Traumatic rupture of the descending thoracic aorta
Orend, K.H.; Kirchdorfer, B.; Sunder-Plassmann, L.
Annali Italiani di Chirurgia 67(1) 21-23; Discussion: 23-25
1996
ISSN/ISBN: 0003-469X PMID: 8712613 Document Number: 461532
Timing and tactics in the repair of the traumatic ruptured thoracic aorta are matter of controversy ever since. The unmeasurable risk of a consecutive rupture favours a primary repair, concomitant injuries, however, a delayed repair. In single injuries of the thoracic aorta the clamp/repair procedure within 24 hours generates acceptable results with an overall mortality of 4 to 8% and a risk of ischemic myelopathy of 8 to 10%. Delayed repair reduces these figures not at all. Extracorporal circulation produces rather worse results in contrast to clamp/repair procedures. In cases of severe concomitant injuries, e.g. brain damage, hemorrhage and open fractures a delayed repair after cardiopulmonary reconstitution is required. In cases with posttraumatic pulmonary insufficiency the risk of surgical procedure itself is much higher than the risk of a second rupture of the traumatized thoracic aorta. We demonstrate our tactics in the repair of traumatic rupture of the descending aorta displaying clinical operated 1992/93.