title: Traumatic rupture of the thoracic aorta: ten years of delayed management.
abstract: 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.
authors.affiliation: Department of Cardiac Surgery, University of Bologna, Bologna, Italy. dpacini@hotmail.com
authors.forename: Davide
authors.initials: D
authors.lastname: Pacini
authors.forename: Emanuela
authors.initials: E
authors.lastname: Angeli
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.forename: Luigi
authors.initials: L
authors.lastname: Lovato
authors.forename: Guido
authors.initials: G
authors.lastname: Rocchi
authors.forename: Luca
authors.initials: L
authors.lastname: Di Marco
authors.forename: Marcello
authors.initials: M
authors.lastname: Bergonzini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grillone
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Bartolomeo
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009566:Nitrates; D014665:Vasodilator Agents