title: Traumatic rupture of thoracic aorta. Diagnosis and management.
abstract: Of six cases of thoracic aortic rupture, four were acute and two were chronic. In the four acute cases, suspicious findings were an appreciably widened mediastinum, upper-extremity hypertension, change in pulse amplitude, or, more hopefully, generalized hypertension, left intraclavicular systolic murmur, and loss of posterior aortic shadow on chest x-ray film. Preoperative angiography was essential. Three of four acute aortic transections (one with aortic arch involvement) had complicated associated injuries that necessitated delay in aortic surgical repair; antihypertensive drugs, including propranolol hydrochloride, were used for support in the interval. Perfusion by femoral vein-femoral artery cardiopulmonary bypass was used. All four patients were operated on successfully without residual complications. Two patients with chronic conditions were recommended for surgery; one was successfully operated on, using aorto-aortic bypass. Another patient, 27 years postinjury, refused operation. Postoperative arteriograms were performed for baseline observations of graft and suture-line characteristics in all cases.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis; D001019:Aortic Rupture / Q000175:diagnosis* / Q000601:surgery; D001027:Aortography; D002315:Cardiopulmonary Bypass; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic