Rupture of the thoracic aorta: emergency treatment and management of chronic aneurysms.

Between 1957 and 1983, 58 patients were treated in our institution for traumatic rupture of the thoracic aorta. Seven patients had acute ruptures and 51 had traumatic aneurysms. Surgical correction of the lesion was obtained by means of left femoral artery bypass in 17 patients, femoral artery-femoral vein bypass in five patients, and external shunt in three patients. After 1975, simple aortic cross-clamping was used in 33 patients. There was one death 1 week after a procedure for ventricular fibrillation. Paraplegia occurred in two patients, and both cases were correlated with hypotensive episodes. From this experience and that of others, it was determined that an aortogram should be performed in all patients suspected of having highspeed deceleration trauma, and that such patients should undergo surgical repair as soon as possible after diagnosis.