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Successful Open Surgical Repair of Traumatic Stanford Type B Thoracic Aortic Dissection Following Motorcycle Trauma:
Nabil Y Al Madhwahi1, Ali M Fadhel2, Yahya A Al-Modwahi3
1Department of Vascular Surgery, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, YEM.
Abstract:
Traumatic thoracic aortic injury represents one of the most life-threatening complications of blunt chest trauma and is associated with substantial morbidity and mortality if not promptly recognized and treated. Rapid deceleration mechanisms may produce intimal disruption of the aortic wall, resulting in dissection, false lumen formation, and potential aortic rupture. We report the case of an 18-year-old previously healthy male patient who presented with chest pain and hemothorax three days after a motorcycle accident. Computed tomography angiography (CTA) demonstrated a Stanford type B traumatic aortic dissection, characterized by an intimal flap originating approximately 3 cm distal to the left subclavian artery and extending along the proximal descending thoracic aorta. The maximal aortic diameter measured approximately 2.6 cm, which was within the expected range for the patient's age. The patient was successfully treated with emergency open surgical repair through a left posterolateral thoracotomy with interposition of a Dacron graft. Postoperative recovery was uneventful, and follow-up imaging confirmed graft patency with restoration of normal aortic flow. The patient was discharged on postoperative day 14 in a stable condition. This case highlights the importance of early diagnosis and timely surgical intervention in traumatic thoracic aortic dissection. In resource-limited settings where endovascular therapy may not be available, conventional open surgical repair remains a reliable and life-saving therapeutic option.

