Chronic traumatic aneurysms of the thoracic aorta

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Vascular Surgery

Background:

• Post-traumatic aneurysms of the thoracic isthmus are rare but serious complications, often resulting from motor vehicle accidents.
• A significant proportion of patients (39%) may not present with obvious thoracic trauma, and many (89%) have associated injuries.

Purpose of the Study:

• To review surgical outcomes for post-traumatic aneurysms of the thoracic isthmus.
• To analyze patient demographics, injury mechanisms, presentation, and treatment strategies.

Main Methods:

• Retrospective review of 18 patients operated on for post-traumatic thoracic isthmus aneurysms between 1975 and 1985.
• Surgical repair techniques included prosthetic Dacron tubes, patches, or direct sutures, with varying methods of aortic cross-clamping and bypass.

Main Results:

• Eighteen patients underwent surgical repair, with most injuries caused by motor vehicle accidents.
• Elective repair in 17 patients resulted in no hospital or late mortality, though one experienced regressive paraplegia.
• One emergency case for an infected aneurysm had operative mortality.

Conclusions:

• Surgical repair of post-traumatic thoracic isthmus aneurysms can be performed with excellent results, particularly in elective settings.
• Effective management involves timely diagnosis and appropriate surgical techniques, even years after the initial trauma.