Blunt traumatic aortic injuries of the ascending aorta and aortic arch: A clinical multicentre study

Abstract

Traumatic aortic injuries of the ascending aorta/arch should be considered in any major thoracic trauma patient presenting cardiac tamponade, aortic valve regurgitation and/or myocardial contusion. These aortic injuries are also associated with a high incidence of neurological injuries, which can be just as lethal as the aortic injury, so treatment priorities should be modulated on an individual basis.

Ascending Aortic Injuries Following Blunt Trauma

“…Spinal injuries were reported in 23% of patients . Paraplegia was not described upon admission and after surgery in any of these cases except ours.…”

“…We reviewed cases of ascending aortic injury from 1998 to present using PubMed with the search terms “traumatic ascending aortic injury.” We found 43 cases (including our present patient presentation) in the literature and details are summarized in Table and Table . There were five cohort observations which included 24 cases (Table ) and 19 case reports (Table ) . The patients demographics were available in a total of 19 cases, which consisted of the majority of male patients with mean age of 45.4 years old (Table ).…”

Neurologic Complications of Aortic Disease and Surgery

“…73 Many of these patients die immediately, but some present with an acute paraplegia. 73 Many of these patients die immediately, but some present with an acute paraplegia.…”

Delayed Ascending Aorta Replacement in Blunt Chest Trauma with Aortic Injury

“…In addition, other coexistent injuries such as fractured ribs and pulmonary contusion with the same chief complaints may mask the manifestations of cardiac injury. Mosquera et al [7] reported that significant aortic regurgitation (AR) developed in 12% of patients with injuries at the ascending aorta as a consequence of the thoracic trauma. Proposed mechanisms that contribute to BAI include shearing forces, rapid deceleration, hydrostatic forces, and osseous pinch [8].…”