Blunt innominate injury: a report of three cases.

Three consecutive successful repairs of innominate artery tears caused by blunt trauma are reported. Attention is called to the fact that the innominate artery is the second most common site of great vessel injury in this setting. The liberal use of standard angiography and subtraction techniques after high kinetic energy blunt trauma is encouraged. Once the injury is diagnosed, expeditious repair must be undertaken using the principles of adequate exposure for proximal and distal control and careful assessment of cerebral collateral blood flow. Median sternotomy, with a cervical extension if necessary, is the incision of choice. Successful repair is the usual outcome.