Graft replacement of post-traumatic thoracic aortic aneurysm: Results without bypass or shunting

Open repair of chronic post-traumatic aneurysms of the aortic isthmus: The value of direct aortoaortic anastomosis

“…Excellent results have also been reported in the literature. [6][7][8][9][10][11][12][13][14][15] The poor natural history of chronic post-traumatic aneurysm has been documented in previous studies by Bennett and Cherry 1 in 1967 and by Finkelmeier et al 2 in 1982. In a collected series of 60 untreated patients, Finkelmeier et al 2 reported 20 deaths (33%) caused by aneurysm-related complications, with 17 ruptures that included two aortoesophageal fistulas.…”

“…Conventional repair is performed by a left posterolateral thoracotomy. Except for a few authors, 6,15 there is little discussion on the use of DAP. Our preference is for partial femorofemoral CPB, mainly because it provides optimal oxygenation and can be converted into full CPB for deep hypothermic circulatory arrest.…”

“…With the exception of a few recent case reports, [3][4][5] a consensus has progressively formed in favor of surgical treatment for all low-risk patients. [6][7][8][9][10][11][12][13][14][15] Although endovascular aortic repair (EVAR) with stent grafts has been increasingly popular in recent years, especially in acute aortic trauma, [16][17][18][19] its use for the treatment of chronic post-traumatic aneurysm of the descending thoracic aorta remains controversial. Some recommend EVAR only for patients with major surgical risks, 20 and others tend to extend indications to all patients.…”

Diagnostik und Therapie thorakaler Gefäßverletzungen

“…Nur wenige Fälle einer erfolgreichen Rekonstruktion sind bekannt. Penetrierende Wunden der ascendierenden Aorta und des Aortenbogens können relativ einfach durch eine laterale Aortorrhaphie versorgt werden [6,7] These ist aber nach neueren Erkenntnissen nicht haltbar [36,37,39]. Ebenso konnte bisher für kein anderes unterstützendes Verfahren wie den Einsatz der extrakorporalen Zirkulation oder intraoperative Shunts eine Überlegenheit nachgewiesen werden.…”