Penetrating injuries involving the intrathoracic great vessels.
Forty-four consecutive patients with injuries to the intrathoracic great vessels admitted to our department from January 1982 to June 1994 were reviewed retrospectively. Forty-two patients (95%) sustained stabwounds and 2 (5%) patients had gunshot wounds. The most frequent radiological abnormality was mediastinal widening in 26 patients (59%). Eighteen patients (41%) were haemodynamically stable on admission with the remainder being unstable (46%), agonal (11%) or lifeless (2%). Twenty-two patients (50%) underwent angiography with 1 false-negative study. A total of 48 arterial and 16 venous injuries were identified with the innominate artery (N = 17, 39% of patients) and left innominate vein (N = 8, 18% of patients) the most frequently injured structures. Associated injuries to thoracic viscera occurred in 13 patients (30%). Two patients required cardiopulmonary bypass to repair their injuries. Arterial shunts were not used in any case. Overall mortality was 5% (2/44) and complications occurred in 7 patients (16%).
Fulton
J O
JO
Department of Cardiothoracic Surgery, University of Cape Town.
de Groot
K M
KM
Buckels
N J
NJ
von Oppell
U O
UO
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013895:Thoracic Arteries / Q000293:injuries*; D013898:Thoracic Injuries / Q000175:diagnosis / Q000601:surgery*; D014948:Wounds, Gunshot / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*; D014951:Wounds, Stab / Q000601:surgery