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The Annals of Thoracic Surgery, Vol 38, 586-591, Copyright © 1984 by The Society of Thoracic Surgeons
HF Olivier Jr, TD Maher, GA Liebler, SB Park, JA Burkholder and GJ Magovern
Traumatic blunt thoracic aortic injury is a clinical entity of increasing
incidence. After the diagnosis of traumatic tear of the aorta is made,
there is some controversy over whether the aorta should be repaired using
cardiopulmonary bypass, a heparinized shunt, or cross- clamping and graft
interposition without a shunt or bypass. At Allegheny General Hospital, 19
patients were treated for traumatic tears of the thoracic aorta between
July 1, 1977, and June 30, 1983. They can be divided into two groups: Group
1 (July 1, 1977, through October 31, 1981), in which no shunt or bypass or
only a heparinized shunt was used, and Group 2 (November 1, 1981, through
June 30, 1983), in which left atrium-femoral artery bypass was performed
using a BioMedicus heparinless pump and tubing. Among the 10 patients in
Group 1, 4 died and 2 had paraplegia postoperatively. Among the 9 patients
in Group 2, 1 died and none experienced paraplegia following operation. We
believe that the BioMedicus centrifugal pump is a simple, safe means of
perfusing the lower body, kidneys, and spinal column without necessitating
heparinization in a patient with multiple injuries or the placement of a
cumbersome heparinized shunt. Because of the simplicity and the reliability
demonstrated, this pump should be considered for use in all patients with
traumatic tears of the thoracic aorta.
ARTICLES
Use of the BioMedicus centrifugal pump in traumatic tears of the thoracic aorta
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