Thoracic aortic injury. A ten-year experience.

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Thoracic Surgery

Background:

• Traumatic disruption of the thoracic aorta is a life-threatening injury.
• Historically, repair involved complex techniques like cardiopulmonary bypass.

Purpose of the Study:

• To evaluate the safety and efficacy of direct suture repair for acute traumatic thoracic aortic disruption.
• To analyze outcomes and identify factors influencing mortality and morbidity.

Main Methods:

• Retrospective review of 41 patients with traumatic thoracic aortic disruption treated between 1974 and 1983.
• Analysis of repair techniques, including direct suture, shunts, and clamp-and-sew methods.
• Assessment of hospital mortality, associated injuries, and neurological outcomes (spinal cord injury).

Main Results:

• 37 patients underwent thoracotomy for definitive repair, with a 16.22% hospital mortality rate.
• Associated injuries were significant contributing factors to mortality.
• 5.41% of patients experienced postoperative spinal cord injury; 4 patients were discharged with spinal cord deficits.
• Most injuries were located distal to the left subclavian artery (97.56%).

Conclusions:

• Direct suture repair is a safe and effective technique for acute traumatic thoracic aortic disruption.
• Abandonment of cardiopulmonary bypass in favor of simpler techniques improved outcomes.
• Early repair during the acute episode is crucial for successful outcomes.