Abstract
A 55 year-old man was crashed under stainless steel plates 300 kg in weight. He was diagnosed as left lung contusion, fracture of left 3rd–5th ribs and blunt aortic injury (BAI) with dissection of aortic arch to descending aorta and mediastinal hematoma. As CT revealed the increase of mediastinal hematoma within two hours after injury, emergency intervention was indicated. To avoid, left thoracotomy, extracorporeal circulation and hypothermic circulatory arrest for the replacement of arch to descending aorta, TEVAR was performed after the initiation of right axillary to left common carotid and left axillary bypass with 8×8 mm Gore-texTM graft. The operation time was 225 minutes and intraoperative blood loss was 50 ml. He discharged home 14 days after surgery and returned to job 1 month after. Postoperative CT revealed no endoleak and patency of bypass graft. This is a case report of TEVAR with supra-aortic bypass to treat BAI without other life-threatening injury.
