Early surgical repair in traumatic rupture of the thoracic aorta. Report of 9 cases and review of the current concepts

Ten patients with rupture of the aortic isthmus due to blunt trauma were subjected to early surgical intervention with nine survivors (mortality 10%). A high degree of suspicion is necessary in order to make an early diagnosis. Left atrium (LA) to femoral artery (FA) bypass using systemic heparinization was used in all cases and bypass instituted before the aorta was prepared for clamping. Advantages of LA to FA bypass are as follows: (a) Technically easy; (b) Better control of patient during preparation of the aorta for clamping; (c) Provides the surgeon with more time to perform a safe operation.