Primary repair of traumatic aortic rupture: a preferred approach.
Eighty patients with traumatic rupture of the thoracic aorta were treated. Seven patients died during the initial resuscitation. Forty-three patients underwent surgical repair using the clamp-and-sew technique; 14 patients had a heparin-bonded shunt placed, and 16 patients were repaired using cardiopulmonary bypass. An interposition Dacron graft was used in only 19 patients (26%). The last 32 consecutive patients underwent primary repair of the ruptured aorta. Overall mortality was 19.2% (14 of 80); 9 of 14 patients (64%) had laparotomies along with the aortic repair, and 13 of 14 patients (92%) had three or more associated major injuries. Paraplegia occurred in four cases (5.6%). Traumatic aortic rupture remains a difficult surgical problem. Primary repair, without graft interposition, is the preferred technique and can be accomplished even when the two aortic ends have retracted several centimeters.
Schmidt
C A
CA
Department of Surgery, Loma Linda University, California.
Wood
M N
MN
Razzouk
A J
AJ
Killeen
J D
JD
Gan
K A
KA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D010264:Paraplegia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D014656:Vascular Surgical Procedures / Q000379:methods