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Original Articles: Adult Cardiac

Endovascular Stenting for Traumatic Aortic Injury: An Emerging New Standard of Care

^a Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland
^b Division of Vascular Surgery, University of Maryland School of Medicine, Baltimore, Maryland
^c R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland

Accepted for publication January 28, 2008.

^_* Address correspondence to Dr Moainie, Division of Cardiac Surgery, N4W94, 22 S Greene St, Baltimore, MD 21201 (Email: smoainie{at}smail.umaryland.edu).

Presented at the Forty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 29–31, 2007.

Background: Thoracic aortic injury remains a leading cause of death after blunt trauma. Thoracic aortic stents have the potential to treat aortic tears using a less invasive approach. We have accumulated the largest series of patients treated with blunt thoracic aortic injury over a 2-year period.

Methods: From July 2005 to present, 26 patients presenting with blunt aortic injury were treated with thoracic aortic endografting; these patients were retrospectively compared with the prior 26 patients presenting with similar aortic injury who were treated by open surgical repair. A Severity Characterization of Trauma score calculated for each patient predicts mortality based on severity of injury and degree of physiologic derangement on presentation.

Results: Patients treated with endografting had a significantly shorter length of stay, less intraoperative blood loss, decreased 24-hour blood transfusion, and lower incidence of postoperative tracheostomy compared with patients undergoing open repair. Survival in both groups was similar despite a trend toward higher injury severity among patients treated with endografting.

Conclusions: This early experience suggests that aortic endografting may provide a safe and efficient treatment of aortic tears that cardiac surgeons can be successful in employing.

This article has been cited by other articles:

				J. Barnard, J. Humphreys, and M. N. Bittar Endovascular versus open surgical repair for blunt thoracic aortic injury Interactive CardioVascular and Thoracic Surgery, September 1, 2009; 9(3): 506 - 509. [Abstract] [Full Text] [PDF]

				H. Takagi, H. Manabe, N. Kawai, S.-n. Goto, and T. Umemoto Endovascular Versus Open Repair for Blunt Thoracic Aortic Injury Ann. Thorac. Surg., January 1, 2009; 87(1): 349 - 350. [Full Text] [PDF]

				S. L. Moainie and B. P. Griffith Invited Commentary Ann. Thorac. Surg., September 1, 2008; 86(3): 786 - 786. [Full Text] [PDF]