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Ann Thorac Surg 1985;39:531-537
© 1985 The Society of Thoracic Surgeons

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Articles

Traumatic Rupture of the Aorta: Emergency Operation

From the Departments of Surgery, the University of Tennessee, Baptist Memorial Hospital, and the Veterans Administration Hospital, Memphis, TN

^* Address reprint requests to Dr. Pate, University of Tennessee, Department of Surgery, 956 Court, Room 2G07, Memphis, TN 38163

Fifty-nine patients who had traumatic aortic rupture in the area of the isthmus and were treated less than one week after injury were studied. Most patients (N = 47) underwent repair using pump-oxygenator partial bypass; 7 had simple cross-clamping. Paraplegia developed in 4 during operation. One patient died of a head injury after receiving heparin for bypass.

The experience with these patients and a critical review of the literature indicate that the use of extracorporeal circulation and avoidance of hypoxia and hypercapnia may decrease the probability of paraplegia. When laparotomy preceded thoracotomy, there were no clearly deleterious effects of heparinization.

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