Penetrating wound of the arch of the aorta

A case of a penetrating wound of the aortic arch was admitted 30 minutes after injury with orthopnoea, mild hypotension and distension of the cervical and brachial veins. Radiography showed mediastinal widening. Pericardiotomy and mobilization of the arch of the aorta facilitated control of haemorrhage and aortography without the use of either partial or total cardiopulmonary bypass.