title: Technical considerations in the repair of combined aortic arch and diaphragm rupture after blunt trauma.
abstract: Rupture of the aortic arch and laceration of the diaphragm after blunt trauma are two serious lesions that are difficult to manage. (1,2) We repaired both lesions in a patient with an anterior approach (i.e., a median sternotomy and a superior median laparotomy). The repair, carried out during extracorporeal circulation, turned out to be relatively easy to perform. The potential dangers associated with the use of cardiopulmonary bypass after blunt trauma must be acknowledged. In selected cases, however, when no strong contraindications to the administration of anticoagulation exist, the anterior approach and the use of cardiopulmonary bypass offer an excellent exposure for the repair of both lesions.
authors.affiliation: Cardiovascular Surgery, University Hospital, 100 Ramistrasse, 8091 Zurich, Switzerland. rene.pretre@chi.usz.ch
authors.forename: R
authors.initials: R
authors.lastname: Prêtre
authors.forename: M
authors.initials: M
authors.lastname: Maeder
authors.forename: M I
authors.initials: MI
authors.lastname: Turina
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000293:injuries; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D003964:Diaphragm / Q000293:injuries*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000601:surgery*