Traumatic rupture of the thoracic aorta with reference to 34 operated cases

34 cases of traumatic rupture of the aortic isthmus have been operated on since 1963: 14 acute ruptures and 20 secondary false aneurysms. Diagnosis was confirmed by aortography. A special feature seen in cases of total transsection is described. Partial extracorporeal bypass was used in 29 cases and direct cross-clamping in 5 cases. Two techniques were used: direct end-to-end anastomosis in 9 patients and Dacron graft interposition in 25 cases. Primary end-to-end anastomosis more often was used in cases of early operation and partial rupture. Hospital mortality was 2 patients in the group of acute ruptures and 0 patient in chronic false aneurysm group. It was related to brain damage or sequelae of prolonged shock. Post-operative course was uneventful but 4 cases of respiratory failure and 4 cases of neurologic disturbances (2 brain dysfunctions and 2 spinal cord dysfunctions). These complications were transient and the patients recovered without sequelae. Clinical results have been recently appreciated in every long-term survivor (mean follow-up: 5 years) and are excellent. Angiographic controls undergone in 10 patients have shown no abnormalities.