Abstract Six patients underwent emergency surgery for descending aortic injury following blunt trauma to the chest; three survived. Associated injury was a critical factor in two of the three patients who died. In the third patient, prolonged ischemia of the lower half of the body due to total aortic distraction with a distal aortic flap produced irreversible changes that were manifest during reperfusion of the body. Angiography is recommended if the patient's condition is stable and other injuries demanding immediate surgical attention are not present. If, however, there are other serious injuries and adequate distal perfusion, then these other injuries should be corrected before aortic repair is undertaken. References 1. Blair E, Topuzlu C, Deane RS: Major blunt chest trauma . Curr Prob Surg , (May) 1969, pp 1-64. 2. Kirsh MM, Kahn DR, Crane JD, et al: Repair of acute traumatic rupture of the aorta without extracorporeal circulation . Ann Thorac Surg 10:227-236, 1970.Crossref 3. Beall AC Jr, Arbegast NR, Ripepi AC, et al: Aortic laceration due to rapid deceleration: Surgical management . Arch Surg 98:595-601, 1969.Crossref 4. Kahn AM, Joseph WL, Hughes RK: Traumatic aneurysms of the thoracic aorta: Excision and repair without graft . Ann Thorac Surg 4:175-181, 1967.Crossref 5. Freed TA, Bosher LH: Arteriographic demonstration of laceration of great vessels secondary to blunt trauma . Radiology 90:88-89, 1968.Crossref 6. Flaherty TT, Wegner GP, Crummy AB, et al: Non-penetrating injuries to the thoracic aorta . Radiology 92:541-546, 1969.Crossref 7. Krause AH, Ferguson JB, Weldon CS: Thoracic aneurysmectomy utilizing the TDMAC-heparin shunt . Ann Thorac Surg 14:123-132, 1972.Crossref 8. Symbas PN, Tyras DH, Ware RE, et al: Traumatic rupture of the aorta . Ann Surg 178:6-12, 1973.Crossref 9. Sutorius DJ, Schreiber JT, Helmsworth JA: Traumatic disruption of the thoracic aorta . J Trauma 13:583-590, 1973.Crossref 10. Reul GJ, Mattox KL, Beall AC, et al: Recent advances in the operative management of massive chest trauma . Ann Thorac Surg 16:52-66, 1973.Crossref 11. Yeo MT, Domanskis EJ, Bartlett RH, et al: Penetrating injuries of the abdominal aorta . Arch Surg 108:839-842, 1974.Crossref 12. Abbott WM, Austen WG: The reversal of renal cortical ischemia during aortic occlusion by mannitol . J Surg Res 16:482-489, 1974.Crossref 13. Berkowitz HD, Shetty S: Renin release and renal cortical ischemia following aortic cross clamping . Arch Surg 109:612-617, 1974.Crossref 14. Provan JL, Fraenkel GJ, Austen WG: Metabolic and hemodynamic changes after temporary aortic occlusion in dogs . Surg Gynecol Obstet 123:544-550, 1966. 15. Cafferata HT, Robinson AJ, Blaisdell FW: Coagulation changes in renal ischemia . Surg Forum 19:31-32, 1968. 16. Herendeen TL, King H: Transient anuria and paraplegia following traumatic rupture of the thoracic aorta . J Thorac Cardiovasc Surg 56:599-602, 1968. 17. Alley RD, Van Mierop LHS, Li EY, et al: Traumatic aortic aneurysm: Graftless excision, anastomosis . Arch Surg 83:300-305, 1961.Crossref 18. Reul GJ, Kabbani SS, Sandiford FM, et al: Repair of coarctation of the thoracic aorta by patch graft angioplasty . J Thorac Cardiovasc Surg 68:696-704, 1974. 19. Billy LJ, Amato JJ, Rich NM: Aortic injuries in Vietnam . Surgery 70:385-391, 1971.
Archives of Surgery – American Medical Association
Published: Sep 1, 1975