Traumatic rupture of the thoracic aorta: ten years of delayed management.
OBJECTIVE
Traumatic rupture of the thoracic aorta is a highly fatal condition in which patient outcome is strongly conditioned by other associated injuries. Delayed aortic treatment has been proposed to improve results.


METHODS
The charts of 69 patients with traumatic rupture of the thoracic aorta observed between 1980 and 2003 were reviewed. Patients were grouped according the timing of repair: group I, immediate repair (21 patients); and group II, delayed repair (48 patients). In group II, 45 patients were treated surgically or by endovascular procedure.


RESULTS
In-hospital mortalities were 4 of 21 patients (19%) in group I and 2 of 48 patients (4.2%) in group II. There were 3 cases of paraplegia in group I and none in group II.


CONCLUSIONS
Improvement of patient outcome with traumatic rupture of the thoracic aorta can be achieved by delaying surgical repair until after management of major associated injuries if there are no signs of impending rupture. Endovascular treatment is feasible and safe and may represent a valid alternative to open surgery in selected cases.
Pacini
Davide
D
Department of Cardiac Surgery, University of Bologna, Bologna, Italy. dpacini@hotmail.com
Angeli
Emanuela
E
Fattori
Rossella
R
Lovato
Luigi
L
Rocchi
Guido
G
Di Marco
Luca
L
Bergonzini
Marcello
M
Grillone
Giovanni
G
Di Bartolomeo
Roberto
R
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002423:Cause of Death; D002648:Child; D003422:Critical Care; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009104:Multiple Trauma; D009566:Nitrates / Q000627:therapeutic use; D010264:Paraplegia / Q000209:etiology; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009566:Nitrates; D014665:Vasodilator Agents