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Published on: March 26, 2018
Traumatic thoracic aortic rupture in the pediatric patient
G D Trachiotis1, J E Sell, G D Pearson
1Division of Cardiothoracic Surgery, Children's National Medical Center, Washington, DC 20010, USA.
The Annals of Thoracic Surgery
|September 1, 1996
Summary
Pediatric traumatic thoracic aortic rupture is rare but requires prompt diagnosis and management. Early detection using advanced imaging and a systematic approach improves outcomes for these severely injured children.
Area of Science:
- Pediatric Trauma Surgery
- Thoracic Aortic Injury
- Blunt Force Trauma Management
Background:
- Traumatic thoracic aortic rupture is an infrequent yet severe injury in pediatric patients.
- Limited data exists on factors influencing occurrence, diagnosis, management, and outcomes in children under 17.
Purpose of the Study:
- To identify factors influencing pediatric traumatic thoracic aortic rupture.
- To evaluate diagnostic and management strategies for improving outcomes.
Main Methods:
- Retrospective review of 6 pediatric patients (ages 8-16) treated for blunt thoracic aortic rupture.
- Diagnosis confirmed via aortography, CT, or TEE; repair utilized cardiopulmonary bypass or clamp and sew techniques.
Main Results:
- Complete transections at the ligamentum arteriosum occurred in 83% of cases.
- Associated injuries were common; 80% of patients were not wearing seat belts.
- No deaths occurred; all patients survived with improved function in one case of paraplegia.
Conclusions:
- A high index of suspicion is crucial for diagnosing aortic injury in severely injured children.
- Selective use of CT and TEE is recommended for diagnosis.
- Prompt diagnosis and management contribute to favorable outcomes.
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