Anesthetic management of aortic trauma

Most of the increasing number of ruptures of the thoracic aorta are caused by traffic accidents. Only a minority arrive sufficiently in time at the hospital to receive medical attention. The diagnosis is very difficult to make both on clinical and radiologic findings alone. An aortography is necessary when there is the slightest suspicion of aortic lesion. The lesions are mostly found in the isthmic region of the descending aorta. This and other localisations are easily explained when some specific anatomic, mechanical and congenital factors are considered. Surgical repair should be carried out in all cases as fast as possible. During repair attention must be directed toward the prevention of kidney and spinal cord injury and equally to prevent proximal hypertension and overload during clamping of the aorta.