A unified approach to the torn thoracic aorta

In a 3-year experience treating 12 patients with blunt torn thoracic aorta, the repair technique was "clamp and sew" with an intraluminal graft in the initial six patients and partial left heart bypass using a centrifugal pump in the more recently treated six. Patients in the two groups were similar in regard to age, sex, and injury severity score. In the intraluminal graft group, graft insertion was abandoned for sutured anastomosis in two patients. Two patients sustained spinal cord ischemia, and two developed hypertension due to "pseudo-coarctation" syndrome. Because of these side effects related to the performance of intraluminal graft, partial left heart bypass was adopted as our routine procedure and was successful in all subsequent patients. Based on our experience and on reports in the current literature, we recommend left atrial-femoral bypass with the centrifugal pump for repair of the torn thoracic aorta.