Innominate vascular injury
Related Experiment Videos
Insights
Major cardiovascular injuries, particularly to the innominate artery, are increasingly common. Successful surgical management is achievable without cardiopulmonary bypass or arterial shunts.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Vascular Surgery
Background:
- Innominate artery injuries and other major cardiovascular trauma are increasingly prevalent.
- Penetrating trauma often affects the distal innominate artery and veins, while blunt trauma typically impacts the proximal innominate artery.
- Associated injuries to the subclavian and carotid arteries are more common with penetrating trauma.
Purpose of the Study:
- To review the management strategies for innominate artery injuries.
- To highlight the importance of selecting appropriate surgical incisions based on associated injuries.
- To demonstrate the feasibility of managing innominate artery injuries without cardiopulmonary bypass or shunts.
Main Methods:
- Review of surgical approaches for innominate artery injuries.
- Discussion of operative exposures including median sternotomy with cervical and thoracic extensions.
- Analysis of injury patterns related to penetrating versus blunt trauma.
Main Results:
- Innominate artery injuries are being encountered with greater frequency.
- Penetrating injuries commonly involve distal innominate artery and veins, with frequent associated subclavian/carotid injuries.
- Blunt trauma typically affects the proximal innominate artery.
- Surgical incision selection is guided by associated mediastinal injuries.
- Successful outcomes were achieved without cardiopulmonary bypass or arterial shunts.
Conclusions:
- Effective surgical management of innominate artery injuries is possible.
- Operative strategies should be tailored to the specific injury and associated trauma.
- Cardiopulmonary bypass and arterial shunts are not always necessary for successful outcomes.
Abstract:
Survivors of innominate and other major cardiovascular injuries are being seen with increasing frequency. Penetrating injuries more frequently involve the distal innominate artery and innominate veins. Associated subclavian and carotid artery injuries are more frequent following penetrating trauma. Blunt trauma typically involves the proximal innominate artery. A variety of operative exposures is useful but the selection of incision frequently depends upon the presence or absence of associated mediastinal injuries. Partial or complete median sternotomy in combination with various cervical and thoracic extensions is advised. Successful management of innominate artery injury can be performed without the aid of cardiopulmonary bypass or arterial shunts.