| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1993;55:586-592
© 1993 The Society of Thoracic Surgeons
a Section of Cardiothoracic Surgery, University of Tennessee, Memphis, Tennessee, USA
b Elvis Presley Trauma Center, Memphis, Tennessee, USA
* Address reprint requests to Dr Pate, Department of Surgery, University of Tennessee, 956 Court Ave, Memphis, TN 38163.
Acute cardiac failure, pulmonary edema, and ischemia of the brain, cord, and other structures pose special problems with trauma to the aortic arch and its branches. Data on 93 such cases are reported. Diagnosis was made by clinical examination in hemodynamically unstable patients and led to immediate operation in 61.3%. Patients in stable condition had angiography, which localized the injury and allowed planning of incision and bypass shunts. In left subclavian artery injuries, anterior thoracotomy was best for proximal control regardless of wound entry sites; midline sternotomy with sternocleidomastoid extension was usually adequate for other vessels. Flow was reestablished in all carotid injuries; there were no neurological complications. Temporary or permanent bypass shunts during periods of proximal aortic occlusion were valuable in decreasing cardiac afterload, maintaining circulation to the brain, and allowing an unhurried methodical approach to the hematoma. Occlusion of one or more venae cavae alleviated acute cardiac dilatation during brief periods of ascending aortic clamping. Associated trauma contributed to the high mortality.
This article has been cited by other articles:
|
|
 |
|
  C. A. Nienaber and J. T. Powell Management of acute aortic syndromes Eur. Heart J., January 1, 2012; 33(1): 26 - 35. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Dente and D. V. Feliciano Torso Vascular Trauma at an Urban Level-I Trauma Center Perspectives in Vascular Surgery and Endovascular Therapy, March 1, 2011; 23(1): 36 - 46. [Abstract] [PDF]
|
|
|
|
 |
|
 American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease J. Am. Coll. Cardiol., April 6, 2010; 55(14): e27 - e129. [Full Text] [PDF]
|
|
|
|
 |
|
 WRITING GROUP MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Circulation, April 6, 2010; 121(13): e266 - e369. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Arslan eComment: Decision-making in a high-risk patient. How much you are equipped? Interact CardioVasc Thorac Surg, March 1, 2010; 10(3): 468 - 469. [Full Text] [PDF]
|
|
|
|
|
|
T. J. Goaley, C. J. Dente, and D. V. Feliciano Torso Vascular Trauma at an Urban Level I Trauma Center Perspectives in Vascular Surgery and Endovascular Therapy, June 1, 2006; 18(2): 102 - 112. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Seitelberger, J. Bialy, and M. A. Rajek Repair of stab-wound laceration of the aortic arch using deep hypothermia and circulatory arrest Ann. Thorac. Surg., February 1, 2004; 77(2): 703 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. V. Arom and F. L. Grover Adult cardiac surgery during the first 50 years of the Southern Thoracic Surgical Association Ann. Thorac. Surg., November 1, 2003; 76(90050): S17 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Karmy-Jones, R. DuBose, and S. King Traumatic rupture of the innominate artery Eur J Cardiothorac Surg, May 1, 2003; 23(5): 782 - 787. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Williams Blunt and Penetrating Trauma to the Thoracic Aorta Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2002; 6(2): 77 - 81. [Abstract] [PDF]
|
|
|
|
|
|
T. E. Williams Jr Proximal Aortic Control in Traumatic Rupture of the Thoracic Aorta Ann. Thorac. Surg., June 1, 1998; 65(6): 1797 - 1797. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.O. Fulton, H.D. Louwrens, J. Marr, and J. Hewitson Profound Hypothermia and Total Circulatory Arrest in the Management of a Massive False Aneurysm of the Subclavian Artery: A Case Report Vascular and Endovascular Surgery, March 1, 1997; 31(2): 199 - 203. [Abstract] [PDF]
|
|
|
|
|
|
J. O. Fulton and J. G. Brink Complex Thoracic Vascular Injury Repair Using Deep Hypothermia and Circulatory Arrest Ann. Thorac. Surg., February 1, 1997; 63(2): 557 - 559. [Abstract] [Full Text]
|
|
|
|
|
|
D. R. Flum, A. C. Cernaianu, T. V. Vassilidze, J. H. Cilley JR, M. A. Grosso, M. Maurer, S. E. Ross, and A. J. DelRossi Traumatic Vascular Disruption in the Thoracocervical Region: Surgical Outcome and Predictors of Survival Vascular and Endovascular Surgery, January 1, 1997; 31(1): 21 - 27. [Abstract] [PDF]
|
|
|
|
|
|
J. O. Fulton, M. K. De Groot, and U. O. von Oppell Stab Wounds of the Innominate Artery Ann. Thorac. Surg., March 1, 1996; 61(3): 851 - 853. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
