Surgical Treatment of Traumatic Aortic Rupture

초록

Objectives: Aortic injury due to blunt thoracic trauma is a fatal condition, necessitating the emergent exploration. The purpose of this study is to report our experience of the traumatic aortic rupture and the outcome of the surgical treatment. Methods: Between Jan. 1998 and Aug. 2002, we experienced 6 patients of trumatic aortic rupture. One patient died while waiting for the operation. Remaining 5 patients who underwent operation were reviewed retrospectively. Results: All patients were suffered from the traffic accident. There were 4 males and one female and the age ranged from 18 to 36 years (mean age 29.8 ± 7.0 years). Preoperative chest CT and aortography confirmed the diagnosis of the aortic rupture around the aortic isthmus and the operation was done on the emergent base in all the patients. The techniques of the distal perfusion were Gott shunt in one case and left atrial to femoral bypass in 3 cases. Femorofemoral bypass and hypothermic circulatory arrest was employed in one patient because of frank rupture during dissection. Mean aortic cross clamp time was 67.6 ± 14.7 minuites. All the patients survived the operation. Operative complication developed in 2 patients; unilateral vocal cord palsy in one patient and pneumonia in the other patient. All the patients are in good condition with the follow-up period from 4 months to 47 months. Conclusions: The favorable outcomes could be anticipated in the group of multiple trauma patients with a high degree of suspicion and the vigilence in the dianostic work up and prompt surgical treatment. The surgical results is thought to improve with the aid of the distal perfusion, thus avoiding distal ischemia.