Surgical experience with traumatic rupture of the thoracic aorta

Nine cases of traumatic thoracic aortic rupture (TAR), operated on at St. Marianna University Hospital between July 1980 and December 1988, were reviewed in order to evaluate the role of contrast-enhanced CT in the early diagnosis of TAR. The absence of mediastinal hematoma on CT eliminated the need...

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Published inJournal of cardiovascular surgery Vol. 31; no. 3; p. 359
Main Authors Kawada, T, Mieda, T, Abe, H, Kamata, S, Hinata, S, Ando, N, Funaki, S, Okada, T, Hiekata, T, Yamate, N
Format Journal Article
LanguageEnglish
Published Italy 01.05.1990
Subjects
Accidental Falls
Accidents, Traffic
Adolescent
Adult
Aorta, Thoracic - diagnostic imaging
Aorta, Thoracic - injuries
Aorta, Thoracic - surgery
Aortic Rupture - diagnostic imaging
Aortic Rupture - surgery
Aortography
Emergencies
Hematoma - diagnostic imaging
Hematoma - surgery
Humans
Male
Mediastinal Diseases - diagnostic imaging
Mediastinal Diseases - surgery
Middle Aged
Multiple Trauma - diagnostic imaging
Multiple Trauma - surgery
Thoracic Injuries - diagnostic imaging
Thoracic Injuries - surgery
Tomography, X-Ray Computed
Wounds, Nonpenetrating - diagnostic imaging
Wounds, Nonpenetrating - surgery
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Summary:Nine cases of traumatic thoracic aortic rupture (TAR), operated on at St. Marianna University Hospital between July 1980 and December 1988, were reviewed in order to evaluate the role of contrast-enhanced CT in the early diagnosis of TAR. The absence of mediastinal hematoma on CT eliminated the need for aortography in 30 (38.5%) of the 78 patients suspected of having TAR on the basis of chest roentgenograms. The presence of mediastinal hematoma necessitated aortography in 48 patients. However, operative treatment was carried out without aortography in 3 patients who had specific signs of rupture on CT. CT proved to be a reliable indicator for the selection of the patients who need aortography. As a rule, emergency operations were performed in these patients. Simple aortic crossclamping was employed in 4 patients, and heparinless left heart bypass with the BioPump was performed for spinal cord protection in 2 recent patients without complication of embolization. Use of the BioPump as an adjunct in the repair of TAR appears to be promising.
ISSN:0021-9509
1827-191X