title: Two Aortic Ruptures in Two Months-Role of Cross-Clamp-Associated Late Injury.
abstract: BACKGROUND
  Aortic cross-clamping may lead to iatrogenic tissue damage resulting in immediate or later aortic dissection or rupture.
  
  
  METHODS
  We report on a patient with an acute type B aortic dissection with mega-aortic syndrome whose aorta ruptured twice within 2 months.
  
  
  RESULTS
  The second aortic rupture occurred at the level of prior cross clamping. The pressure along the clamp jaws is distributed unequally. According to the law of the lever, the aortic area near the hinge is under more stress than the aortic area distal to the hinge. Unequal pressure distribution may injure the aorta.
  
  
  CONCLUSIONS
  There is a need to evaluate pressure distribution along the various currently available aortic clamp jaws and to develop the perfect aortic clamp providing equal pressure distribution designed especially to clamp large aortas or those of patients with connective tissue disorders.
authors.affiliation: Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany. Electronic address: bartosz.rylski@universitaets-herzzentrum.de.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Rylski
authors.affiliation: Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Beyersdorf
authors.affiliation: Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Czerny
authors.affiliation: Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Siepe
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D000072226:Computed Tomography Angiography; D003250:Constriction; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome