Chien-Chao Lin1, Kuo-Sheng Liu1, Huan-Wu Chen1, Yao-Kuang Huang2, Jaw-Ji Chu1, Feng-Chun Tsai1, Pyng Jing Lin1. 1. Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc. 2. Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chiayi and Linkou Center, College of Medicine, Chang Gung University, 6.West Sec. Chiapu Road, Putzu City, Chiayi Hsien, 61636, Taiwan, Roc. yaokuang@gmail.com.
Abstract
PURPOSE: This study reviews our 17-year experience of managing blunt traumatic aortic injury (BTAI). METHODS: We analyzed information collected retrospectively from a tertiary trauma center. RESULTS: Between October 1995 and June 2012, 88 patients (74 male and 14 female) with a mean age of 39.9 ± 17.9 years (range 15-79 years) with proven BTAI were enrolled in this study. Their GCS, ISS, and RTS scores were 12.9 ± 3.7, 29.2 ± 9.8, and 6.9 ± 1.4, respectively. Twenty-one (23.8 %) patients were managed non-operatively, 49 (55.7 %) with open surgical repair, and 18 (20.5 %) with endovascular repair. The in-hospital mortality rate was 17.1 % (15/81) and there were no deaths in the endovascular repair group. The mean follow-up period was 39.9 ± 44.2 months. The survivors of blunt aortic injury had lower ISS, RTS, TRISS, and serum creatinine level and lower rate of massive blood transfusion, shock, and intubation than the patients who died, despite higher rates of endovascular repair, hemoglobin, and GCS on presentation. The degree of aortic injury, different therapeutic options, GCS, shock presentation, and intubation on arrival all had significant impacts on outcome. CONCLUSIONS: Shock, aortic injury severity, coexisting trauma severity, and different surgical approaches impact survival. Endovascular repair achieves a superior mid-term result and is a reasonable option for treating BTAI.
PURPOSE: This study reviews our 17-year experience of managing blunt traumatic aortic injury (BTAI). METHODS: We analyzed information collected retrospectively from a tertiary trauma center. RESULTS: Between October 1995 and June 2012, 88 patients (74 male and 14 female) with a mean age of 39.9 ± 17.9 years (range 15-79 years) with proven BTAI were enrolled in this study. Their GCS, ISS, and RTS scores were 12.9 ± 3.7, 29.2 ± 9.8, and 6.9 ± 1.4, respectively. Twenty-one (23.8 %) patients were managed non-operatively, 49 (55.7 %) with open surgical repair, and 18 (20.5 %) with endovascular repair. The in-hospital mortality rate was 17.1 % (15/81) and there were no deaths in the endovascular repair group. The mean follow-up period was 39.9 ± 44.2 months. The survivors of blunt aortic injury had lower ISS, RTS, TRISS, and serum creatinine level and lower rate of massive blood transfusion, shock, and intubation than the patients who died, despite higher rates of endovascular repair, hemoglobin, and GCS on presentation. The degree of aortic injury, different therapeutic options, GCS, shock presentation, and intubation on arrival all had significant impacts on outcome. CONCLUSIONS: Shock, aortic injury severity, coexisting trauma severity, and different surgical approaches impact survival. Endovascular repair achieves a superior mid-term result and is a reasonable option for treating BTAI.
Authors: A H Sepehripour; K Ahmed; J A Vecht; V Anagnostakou; A Suliman; H Ashrafian; A Darzi; T Athanasiou Journal: Eur J Vasc Endovasc Surg Date: 2011-02-22 Impact factor: 7.069
Authors: Marco Di Eusanio; Gianluca Folesani; Paolo Berretta; Francesco D Petridis; Antonio Pantaleo; Vincenzo Russo; Luigi Lovato; Roberto Di Bartolomeo Journal: Ann Thorac Surg Date: 2013-03-28 Impact factor: 4.330
Authors: Donald G Harris; Charles B Drucker; Megan L Brenner; Rajabrata Sarkar; Mayur Narayan; Robert S Crawford Journal: Ann Vasc Surg Date: 2013-06-20 Impact factor: 1.466
Authors: Davy Cheng; Janet Martin; Hani Shennib; Joel Dunning; Claudio Muneretto; Stephan Schueler; Ludwig Von Segesser; Paul Sergeant; Marko Turina Journal: J Am Coll Cardiol Date: 2010-03-09 Impact factor: 24.094
Authors: Eleftherios Sarantis Xenos; David J Minion; Daniel L Davenport; Omar Hamdallah; Nick N Abedi; Ehab E Sorial; Eric D Endean Journal: Eur J Cardiothorac Surg Date: 2008-12-10 Impact factor: 4.191
Authors: A D Hilgenberg; D L Logan; C W Akins; M J Buckley; W M Daggett; G J Vlahakes; D F Torchiana Journal: Ann Thorac Surg Date: 1992-02 Impact factor: 4.330
Authors: Alexander Gombert; Mohammad E Barbati; Martin Storck; Drosos Kotelis; Paula Keschenau; Hans-Christoph Pape; Hagen Andruszkow; Rolf Lefering; Frank Hildebrand; Andreas Greiner; Michael J Jacobs; Jochen Grommes Journal: PLoS One Date: 2017-03-27 Impact factor: 3.240