Repair of traumatic aortic transection: A management protocol and review of twenty-one patients

L. Guvendik, N. R. Davis, A. Starr

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Between 1970 and 1987, 21 patients at St. Vincent Hospital and Medical Center underwent surgery for repair of a transected descending aorta. Nineteen of the transections were a result of trauma secondary to motor vehicle accidents, 1 was secondary to compression injury of the chest, and 1 was the result of a fall. All of the patients had diagnostic chest X-rays and all but one X-ray showed a widened mediastinum. Aortography was carried out in 20 cases. Atrio-femoral bypass was used for all but 2 patients, who had femoro-femoral bypass. The mean cross-clamp time was 53 minutes. Interposition graft was used in 16 patients, an intraluminal graft in 1 patient, and primary repair was performed in 2 patients. Survival was 71%, with 4 of the 21 patients expiring in the operating room (2 before the repair could be undertaken), one patient expiring during a laparotomy 2 days after the aortic repair, and one patient expiring 4 days after the repair. Fifteen patients were discharged alive. Survival and patient care could be improved by careful diagnostic assessment and by following a protocol agreed upon by a team of surgeons.

Original languageEnglish (US)
Pages (from-to)198-201
Number of pages4
JournalThoracic and Cardiovascular Surgeon
Volume36
Issue number4
DOIs
StatePublished - 1988

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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