COMPARATIVE STUDY
JOURNAL ARTICLE

Repair of traumatic aortic rupture: a 25-year experience

A J Razzouk, S R Gundry, N Wang, M J del Rio, D Varnell, L L Bailey
Archives of Surgery 2000, 135 (8): 913-8; discussion 919
10922251

BACKGROUND: Surgical management of traumatic aortic rupture (TAR) is controversial, specifically whether distal aortic perfusion modifies the outcome.

HYPOTHESIS: The outcome of patients who undergo repair of TAR is not dependent on the technique of repair.

DESIGN: Retrospective review.

SETTING: Tertiary care teaching hospital, level I regional trauma center.

PATIENTS: One hundred fifteen victims (aged 5-81 years) of blunt chest trauma with aortic tear, presenting between January 1, 1974, and June 30, 1999.

METHODS: Medical records were reviewed for prehospital and emergency department data, operative findings, and outcome. Statistical comparison was made using a paired 2-tailed t test.

INTERVENTION: Surgical repair of TAR with (group 1) or without (group 2) distal aortic perfusion.

RESULTS: Thirty-two patients in group 1 had TAR repair using active bypass (n = 18) or Gott shunt (n = 14). The clamp-and-sew technique was used in 83 patients (group 2). Primary repair was possible in 14 patients (44%) in group 1 and 69 patients (83%) in group 2. The average aortic cross-clamp time was 48 minutes for group 1 (range, 25-113 minutes) and 20 minutes for group 2 (range, 5-40 minutes) (P<.03). There was no significant difference in hospital mortality (6 [18.7%] of 32 vs 15 [18.1%] of 83) or the incidence of paraplegia (2 [6%] of 32 vs 5 [6%] of 83) between groups 1 and 2. During the last 15 years, 78 patients (73 in group 2) had repair of TAR with an operative mortality rate of 19.2%.

CONCLUSIONS: Acute TAR remains a highly lethal injury with no change in prognosis during the last 2(1/2) decades. Repair of TAR using simple aortic cross-clamping alone is feasible in the majority of patients without increased mortality or spinal cord injury.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
10922251
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"