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A unified approach to the torn thoracic aorta
B L McCroskey1, E E Moore, F A Moore
1Department of Surgery, Denver General Hospital, Colorado 80204.
American Journal of Surgery
|November 1, 1991
Summary
This study compared two thoracic aorta repair methods. Partial left heart bypass using a centrifugal pump proved safer and more effective than intraluminal grafts for blunt aortic tears.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Trauma Surgery
Background:
- Blunt torn thoracic aorta injuries present significant surgical challenges.
- Traditional "clamp and sew" techniques with intraluminal grafts have associated complications.
Purpose of the Study:
- To evaluate the efficacy and safety of two surgical techniques for blunt thoracic aorta repair.
- To compare outcomes between intraluminal grafts and partial left heart bypass.
Main Methods:
- A 3-year retrospective review of 12 patients with blunt thoracic aorta tears.
- Comparison of "clamp and sew" with intraluminal grafts versus partial left heart bypass using a centrifugal pump.
- Analysis of patient demographics, injury severity, and post-operative complications.
Main Results:
- The intraluminal graft group experienced complications including graft failure, spinal cord ischemia, and hypertension (pseudo-coarctation).
- Partial left heart bypass was successful in all subsequent patients without major adverse events.
- Patient groups were comparable in age, sex, and injury severity score.
Conclusions:
- Partial left heart bypass with a centrifugal pump is a recommended and successful technique for thoracic aorta repair.
- This method offers improved safety and efficacy compared to intraluminal grafts for blunt aortic injuries.
- Left atrial-femoral bypass is favored for managing torn thoracic aortas based on this experience and literature review.