[Traumatic rupture of the thoracic aorta].
Nowadays, trauma victims are quickly transported from the scene to the therapeutic facility, therefore, even patients with traumatic aortic rupture (TAR) who were considered to be unlikely to survive several hours in the past are able to have more chance to undergo surgical treatment. In such patients who need emergency surgical repair of TAR regardless of the presence of multiple other organ injuries, massive contrast dye extravasation into the mediastinum is usually demonstrated on the contrast-enhanced computed tomography (CT) images. But, in most of the cases showing a pseudoaneurysm or dissection, delayed aortic repair is preferable when other organ injuries have therapeutic priority. The use of active adjunct means for distal support is definitely advantageous to prevent paraplegia. Heparin-bonded bypass by the use of low dose of heparin or intravenous argatroban is safe and avoids the risk of bleeding of other injured organs.
Kawada
Tadanori
T
First Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Aiba
Masahiro
M
D001013:Aorta, Thoracic / Q000293:injuries* / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D015607:Stents; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods