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Original Articles: Adult Cardiac

Early Outcome of Endovascular Treatment of Acute Traumatic Aortic Injuries: The Talent Thoracic Retrospective Registry

^a Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
^g Department of Emergency Medicine, University of Vienna, Vienna, Austria
^b Department of Radiology, Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France
^c Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
^d Centre Hospitalier Universitaire, Hopital Sainte Marguerite, Marseille, France
^e Radiologie Vasculaire, Hopital Cardiologique CHRU de Lille, Lille, France
^f Department of Cardiology, University Hospital Rostock, Rostock, Germany
^h Cardiovascular Radiology, University Hospital S. Orsola, Bologna, Italy

Accepted for publication June 10, 2009.

^_* Address correspondence to Dr Ehrlich, Dept. of Cardio-Thoracic Surgery, University of Vienna, Währinger Gürtel 18-20, Vienna, A-1090, Austria (Email: marek.ehrlich{at}meduniwien.ac.at).

Presented at the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: Acute traumatic injury of the thoracic aorta (TAI) is a life-threatening complication in patients who sustain deceleration or crush injuries. This study was conducted to examine the results in patients who underwent endovascular repair with the Talent (Medtronic/AVE, Santa Rosa, CA) thoracic stent graft for acute traumatic injury.

Methods: Out of 457 consecutive endograft patients, 41 (9%) were treated for traumatic aortic conditions. There were 36 males with a mean age of 36 ± 14 years. Mean aortic diameter at the time of intervention was 34 mm ± 9 (range, 20 to 70 mm). The mean length of covered aorta was 106 mm (range, 5 to 130 mm) with only one stent graft used in 98% (40) of all cases. Median follow-up period for hospital survivors was 13 months (1.0 to 69.0 months).

Results: Stent graft implantation was technically successful in all cases (100%). One patient died during hospitalization, yielding an overall in-hospital mortality rate of 2.4%. Procedural-related paraplegia was zero and a primary endoleak was observed in 1 patient. Postoperative complications occurred in 4 patients (3 respiratory failures, 1 multiorgan failure). No patient required conversion to open surgical repair.

Conclusions: The treatment of acute traumatic injuries of the descending thoracic aorta with the Talent stent graft is a feasible and safe technique; it provides low morbidity and mortality rates in the early postoperative period, and early results are encouraging. However, long-term studies are worthwhile to evaluate the effectiveness and the durability of this procedure.