Repair of the torn descending thoracic aorta using the centrifugal pump for partial left heart bypass.
OBJECTIVE
To describe the relevant anatomy and sequential technical maneuvers to repair blunt injuries to the descending thoracic aorta with partial left heart bypass.


BACKGROUND
Blunt injury to the descending thoracic aorta remains among the most lethal and morbid of anatomic injuries. Of the techniques of repair which have evolved, "clamp and sew" is simple but has an unacceptable risk of paraplegia. In contrast, partial left heart bypass is more complex but virtually eliminates the risk of paraplegia.


METHODS
We present a detailed management plan for treating blunt injury to the descending thoracic aorta using partial left heart bypass that has evolved over the past 25 years. Preoperative Azā-blockade to reduce the risk of rupture and use of the centrifugal pump to reduce the incidence of paraplegia without the risk of systemic anticoagulation are essential.


RESULTS
We present a detailed description of our management of injuries to the descending thoracic aorta. In our experience, no episodes of postoperative paraplegia have occurred with the use of this technique.


CONCLUSIONS
Blunt injury to the descending thoracic aorta can be safely repaired using partial left heart bypass.
Moore
Ernest E
EE
Denver Health Medical Center University of Colorado Health Sciences Center, Denver, Colorado, USA. ernest.moore@dhha.org
Burch
Jon M
JM
Moore
John B
JB
D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000379:methods; D018611:Heart Bypass, Left / Q000295:instrumentation*; D006801:Humans; D014949:Wounds, Nonpenetrating / Q000150:complications