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Traumatic rupture of thoracic aorta


Authors: V. Třeška 1,3;  F. Šlauf 2,3;  B. Čertík 1,3;  R. Šulc 1,3;  M. Čechura 1,3;  J. Moláček 1,3;  T. Hájek 3,4;  K. Houdek 1,3
Authors place of work: Chirurgická klinika LFUK a FN v Plzni 1;  Radiodiagnostická klinika LFUK a FN v Plzni 2;  Traumatologické centrum LFUK a FN v Plzni 3;  Kardiochirurgické oddělení LFUK a FN v Plzni 4
Published in the journal: Rozhl. Chir., 2012, roč. 91, č. 10, s. 535-538.
Category: Original articles

Práce podpořena Výzkumným projektem P 36 Univerzity Karlovy.

Summary

Introduction:
Thoracic aortic injury (TAI) is burdened with high mortality (80–90%). The diagnostic and therapeutic algorithm has changed radically over the last couple of years. The authors present their experience with diagnosis and treatment of TAI at the University Hospital Trauma Centre.

Material and methods:
24 TAIs were evaluated in a retrospective study, in 20 (83.3%) cases they were part of a polytrauma. The average age of the patients was 39.4 years (20–67). Traffic accidents formed the majority of TAIs (87.5%). Multi-detector computed tomography was used as a basic examination to detect TAI. Thoracic endovascular aortic repair (TEVAR) was the treatment of choice in 21 and open surgery in 3 injured patients.

Results:
The 30-day postoperative mortality was 12.5%, in one case it was associated with TEVAR. 30-day morbidity was 37.5% (circulatory instability, respiratory insufficiency, bronchopneumonia, type I endoleak).

Conclusion:
MDCT and TEVAR are currently the methods of first choice in the diagnosis and treatment of TAI. TAI requires a highly specialized multidisciplinary approach within Trauma Centres providing complex cardiovascular services.

Key words:
thoracic aortic injury – diagnosis – treatment


Zdroje

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Štítky
Surgery Orthopaedics Trauma surgery
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