BACKGROUND: Surgical management of traumatic aortic rupture (TAR) is controversial, specifically whether distal aortic perfusion modifies the outcome. HYPOTHESIS: The outcome of patients who undergo repair of TAR is not dependent on the technique of repair. DESIGN: Retrospective review. SETTING: Tertiary care teaching hospital, level I regional trauma center. PATIENTS: One hundred fifteen victims (aged 5-81 years) of blunt chest trauma with aortic tear, presenting between January 1, 1974, and June 30, 1999. METHODS: Medical records were reviewed for prehospital and emergency department data, operative findings, and outcome. Statistical comparison was made using a paired 2-tailed t test. INTERVENTION: Surgical repair of TAR with (group 1) or without (group 2) distal aortic perfusion. RESULTS: Thirty-two patients in group 1 had TAR repair using active bypass (n = 18) or Gott shunt (n = 14). The clamp-and-sew technique was used in 83 patients (group 2). Primary repair was possible in 14 patients (44%) in group 1 and 69 patients (83%) in group 2. The average aortic cross-clamp time was 48 minutes for group 1 (range, 25-113 minutes) and 20 minutes for group 2 (range, 5-40 minutes) (P<.03). There was no significant difference in hospital mortality (6 [18.7%] of 32 vs 15 [18.1%] of 83) or the incidence of paraplegia (2 [6%] of 32 vs 5 [6%] of 83) between groups 1 and 2. During the last 15 years, 78 patients (73 in group 2) had repair of TAR with an operative mortality rate of 19.2%. CONCLUSIONS: Acute TAR remains a highly lethal injury with no change in prognosis during the last 2(1/2) decades. Repair of TAR using simple aortic cross-clamping alone is feasible in the majority of patients without increased mortality or spinal cord injury.
BACKGROUND: Surgical management of traumatic aortic rupture (TAR) is controversial, specifically whether distal aortic perfusion modifies the outcome. HYPOTHESIS: The outcome of patients who undergo repair of TAR is not dependent on the technique of repair. DESIGN: Retrospective review. SETTING: Tertiary care teaching hospital, level I regional trauma center. PATIENTS: One hundred fifteen victims (aged 5-81 years) of blunt chest trauma with aortic tear, presenting between January 1, 1974, and June 30, 1999. METHODS: Medical records were reviewed for prehospital and emergency department data, operative findings, and outcome. Statistical comparison was made using a paired 2-tailed t test. INTERVENTION: Surgical repair of TAR with (group 1) or without (group 2) distal aortic perfusion. RESULTS: Thirty-two patients in group 1 had TAR repair using active bypass (n = 18) or Gott shunt (n = 14). The clamp-and-sew technique was used in 83 patients (group 2). Primary repair was possible in 14 patients (44%) in group 1 and 69 patients (83%) in group 2. The average aortic cross-clamp time was 48 minutes for group 1 (range, 25-113 minutes) and 20 minutes for group 2 (range, 5-40 minutes) (P<.03). There was no significant difference in hospital mortality (6 [18.7%] of 32 vs 15 [18.1%] of 83) or the incidence of paraplegia (2 [6%] of 32 vs 5 [6%] of 83) between groups 1 and 2. During the last 15 years, 78 patients (73 in group 2) had repair of TAR with an operative mortality rate of 19.2%. CONCLUSIONS: Acute TAR remains a highly lethal injury with no change in prognosis during the last 2(1/2) decades. Repair of TAR using simple aortic cross-clamping alone is feasible in the majority of patients without increased mortality or spinal cord injury.
Authors: Rachel Elizabeth Payne; Rachel Michelle Nygaard; Joss Dean Fernandez; Prateek Sahgal; Chad John Richardson; Mohammad Bashir; Kalpaj Parekh; Panos Nicolas Vardas; Yoshikazu Suzuki; Joel Corvera; Jon Christopher Krook; Domenico Calcaterra Journal: Eur J Trauma Emerg Surg Date: 2019-06-21 Impact factor: 3.693
Authors: José G Ciscato; Verena K Capellini; Andrea C Celotto; Caroline F Baldo; Edwaldo E Joviliano; Paulo R B Evora; Marcelo B Dalio; Carlos E Piccinato Journal: Scand J Trauma Resusc Emerg Med Date: 2010-07-19 Impact factor: 2.953
Authors: Václav Procházka; Jan Roman; František Jalůvka; Tomáš Jonszta; Adéla Vrtková; Leopold Pleva; Vladimír Ječmínek; Jiří Sieja; Radim Brát Journal: Med Sci Monit Date: 2021-11-11