Surgical management of blunt traumatic rupture of the descending thoracic aorta
Chui, W.H.; Chiu, S.W.; Lee, J.W.; Cheung, D.L.; He, G.W.
Annals of Thoracic and Cardiovascular Surgery Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 5(2): 109-112
1999
ISSN/ISBN: 1341-1098 PMID: 10332115 Document Number: 508213
Acute rupture of the descending thoracic aorta following blunt trauma is a life-threatening injury that requires emergent operative intervention. From February 1989 to January 1997, 4 patients with multiple injuries including traumatic rupture in the region of the aortic isthmus were surgically treated at our institution. Diagnosis was confirmed in all patients by aortogram prior to aortic repair. One patient had preoperative paraplegia secondary to an unstable spinal fracture. All patients underwent repair under cardiopulmonary bypass (3 partial, 1 total with hypothermic arrest). The site of rupture was resected and replaced with an interposition artificial graft. There was no perioperative mortality and no additional occurrence of paraplegia. Our experience and a review of the literature indicate that for survivors of traumatic aortic rupture, excellent outcomes can be achieved only if the diagnosis is made early and the surgical treatment is prompt.