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Disruption of aortic arch branches due to nonpenetrating chest trauma

R S Faro, D O Monson, M Weinberg

    Archives of Surgery (Chicago, Ill. : 1960)
    |November 1, 1983
    PubMed

    Insights

    Non-penetrating chest trauma can disrupt major arteries like the innominate, carotid, and subclavian. Surgical repair varied, with cardiopulmonary bypass recommended for complex cases.

    Area of Science:

    • Vascular Surgery
    • Trauma Surgery
    • Thoracic Surgery

    Background:

    • Non-penetrating chest trauma can cause severe injuries to major arteries.
    • Disruption of the innominate, carotid, and subclavian arteries is a rare but critical complication.

    Observation:

    • Six patients with non-penetrating chest trauma and arterial disruption were treated between 1967 and 1979.
    • Diagnosis was confirmed using aortography.
    • Injuries involved the innominate, carotid, and subclavian arteries, with some cases also having bronchial disruptions.

    Findings:

    • Surgical approaches included lateral thoracotomies, sternotomy, and cervical approaches.
    • Repairs ranged from simple oversewing to graft replacement for complex innominate and carotid artery disruptions.
    • One patient died due to multiple vessel and bronchial disruption; cardiopulmonary bypass is recommended for all cases.

    Implications:

    • Early diagnosis and appropriate surgical intervention are crucial for managing these severe vascular injuries.
    • The study highlights the importance of available cardiopulmonary bypass for complex arterial disruptions.
    • Diverse surgical techniques may be required depending on the specific arteries and extent of injury.

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