Abstract
Background: Blunt traumatic rupture of the aorta is a life-threatening condition and has a high mortality rate. However, no therapeutic algorithm has not been established. Endovascular repair has gained rapid acceptance and some excellent results have been reported. The aim of this study is to evaluate the short-term surgical results for blunt aortic injury. Methods: Data from 14 patients (mean age, 36 years; range 16 to 61 years; 12 male, 2 female) with acute traumatic aortic injury treated by surgery between 1985 and 2006 were reviewed retrospectively. The trauma injury score (TRISS) was used to evaluate patients. Probability of survival (Ps) was 55–97.5% (mean 0.89 ± 0.03). Patients were divided into three groups; Group I (Ps < 80%), Group II (80 ≤ Ps < 95%), Group III (Ps ≥ 95%) and surgical results were compared. Results: One patient in Group I, 2 patients in Group II and 5 patients in Group III underwent emergency operations. Elective surgery was performed in 2 patients from Group I, 3 patients from Group II and 1 patient from Group III. Endovascular stent grafting was performed in 1 patient in Group II, and direct suture of the aorta was performed in 1 patient from Group II and 1 patient from Group III. Nine patients were treated with femoro-femoral cardiopulmonary bypass, 1 patient underwent left heart bypass and simple cross-clamping of the aorta was performed in 2 patients. Selective cerebral perfusion was required in 2 patients and circulatory arrest was employed in 2 patients. There was one operative death due to retroperitoneal bleeding. Conclusion: Patients who suffer blunt traumatic rupture of the aorta with multiple organ injury should be evaluated properly on admission. Endovascular stent grafting should be considered especially for high-risk multitrauma patients.
