title: An experimental cadaveric study for a better understanding of blunt traumatic aortic rupture.
abstract: BACKGROUND
  Blunt traumatic aortic rupture (BTAR) is a common catastrophic injury leading to death. Considerable uncertainty remains regarding the pathogenic cause. This study examines the comportment of the heart and the aorta during a frontal deceleration.
  
  
  METHODS
  Accelerometers were placed in the right ventricle of the heart, the aorta, the sternum, and the spine of six trunks removed from human cadavers. Different vertical decelerations were applied to cadavers and the relative motion of these organs was studied (19 tests).
  
  
  RESULTS
  The deceleration recorded in the isthmus of the aorta was always higher that the one recorded in the heart (p < 0.05). The difference of deceleration was 17% and increased with the speed's fall (extremes 5-25%). There was no significant difference of deceleration between the bony structures of the thorax. These results experimentally demonstrate for the first time that the fundamental mechanism of BTAR is sudden stretching of the isthmus of the aorta.
  
  
  CONCLUSIONS
  Four mechanisms are suspected to explain the location of the rupture: two hemodynamic mechanism (sudden increase of intravascular pressure and the water-hammer effect), and two physical mechanisms (sudden stretching of the isthmus and the osseous pinch). A greater understanding of the mechanism of this injury could improve vehicle safety leading to a reduction in its incidence and severity. Future work in this area should include the creation of an inclusive, dynamic model of computer-based modeling systems. This study provides for the first time physical demonstration and quantification of the stretching of the isthmus, leading to a computerized model of BTAR.
authors.affiliation: Laboratoire de Biomécanique appliquée, INRETS-UMTR, Faculté de Médecine Nord, Marseille, France. baque.p@chu-nice.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Baqué
authors.forename: Thierry
authors.initials: T
authors.lastname: Serre
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cheynel
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Arnoux
authors.forename: Lionel
authors.initials: L
authors.lastname: Thollon
authors.forename: Michel
authors.initials: M
authors.lastname: Behr
authors.forename: Catherine
authors.initials: C
authors.lastname: Masson
authors.forename: Jérôme
authors.initials: J
authors.lastname: Delotte
authors.forename: Stéphane-Victor
authors.initials: SV
authors.lastname: Berdah
authors.forename: Christian
authors.initials: C
authors.lastname: Brunet
mesh_terms: D001011:Aorta / Q000033:anatomy & histology / Q000503:physiopathology*; D001019:Aortic Rupture / Q000209:etiology / Q000503:physiopathology*; D002102:Cadaver; D003654:Deceleration / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D014949:Wounds, Nonpenetrating / Q000503:physiopathology*