Traumatic rupture of the thoracic aorta

Abstract

Objectives: To evaluate results in patients who underwent surgery due to a traumatic rupture of the thoracic aorta. Material and Methods: Retrospective analysis comprising 10 patients (9 males and 1 female); aged between 18 and 55 years (mean 36 years), who were operated on between 1992 and 1998 due to rupture thoracic aorta. In 8 patients, the rupture occurred as a result of a traffic accident; and in the 2 other cases, as a result of precipitation. In all cases, the patients sustained multiple associated lesions, which required surgical attention. Four primary sutures and 5 aortic grafts with Dacron were performed. Clamping time ranged between 9 to 50 minutes (mean 35). No distal aortic perfusion techniques were employed. Results: There was one death in the intraoperative series and 2 cases of paraplegia, in both instances in patients with an aortic graft and prolonged clamping time (45 and 50 m. respectively). The remaining number of patients survived with no complications. Conclusions: Surgery must be performed swiftly and on an urgent basis, after other possible vital lesions that provoke hemodynamic instability in the patient are ruled out. A primary suture must be applied whenever possible. Based on the results, we endorse the employment of distal aortic reperfusion, whenever possible.