Traumatic rupture of the descending thoracic aorta.
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.
Orend
K H
KH
Department of Thoracic and Vascular Surgery, University of Ulm Germany.
Kirchdorfer
B
B
Sunder-Plassmann
L
L
D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed