Clamp-and-sew technique for traumatic injuries of the aorta: 20-year experience

Traumatic aortic injuries are associated with high morbidity and mortality, and the ideal operative approach for surgical management is unclear. We analyzed our results with the open clamp-and-sew technique over a 20-year period. Twenty patients with transected aorta were given interposition grafts; 19 of them had multisystem injuries. Mean aortic crossclamp time was 21.7 min (range, 12-30 min). Postoperative complications included pneumonia in 4 patients, acute renal failure in 1, recurrent laryngeal nerve injury in 2, chylothorax in 1, and sepsis of unknown etiology in one. There was no incidence of operation-related paraplegia. Although there was no 30-day mortality, one patient died after 90 days from diffuse axonal injuries to the brain. In experienced hands, the clamp-and-sew technique is effective and safe for the management of traumatic aortic transection.