The Epidemiology of Traumatic Rupture of the Thoracic Aorta in Children: A 13-year Review

A review of vascular surgery in the pediatric population

“…Central vascular injury The central vascular system is an uncommon location of injury, associated with high mortality [1][2][3]. More contemporary experience reported in a recent series documented over two-thirds of patients surviving after central vascular trauma [4].…”

“…Survival to the ER alive is affected by the policies and efficiency of the local emergency response systems. Exclusion of the patients that died prior to arrival at the emergency room invariably will lead to a reduced reported mortality [2]. In addition, a large percentage of penetrating traumas made up the study population, which is typically associated with less systemic injury.…”

“…The remaining vascular tree is adequately managed with adequate proximal and distal control transiently occluding flow to allow for repair. After control, the preferred method of repair has been primary closure of the defect or segmental resection, with the use of autologous graft or synthetic material when extensive injury makes the former options infeasible [1,2,4].…”

Treatment of Traumatic Rupture of the Thoracic Aorta

“…Patients who arrived in the ED alive and subsequently diagnosed either before or after death as having RTA were identified, and their medical records, autopsy data, and police accident reports were reviewed in detail. The follow¬ ing characteristics were noted: (1) age, (2) sex, (3) mechanism of injury, (4) presence of hemodynamic instability, (5) method of diag¬ nosis, (6) time from injury to diagnosis and repair, (7) site and extent of aortic tear, (8) method of repair or attempted repair, (9) method of distal perfusion (if used), (10) cross-clamp times, (11) complications, (12) Blood pressure is usually controlled with short-acting ß-blockers, with careful monitoring before and during the operation.…”

Computed Tomography in the Evaluation of Pediatric Trauma

“…14 In the cases where children survive the events prior to hospitalization, mortality remains significantly higher than in adults, and therefore early identification of aortic injuries is extremely important. CT with angiography has shown great efficacy in identifying aortic injuries and guiding treatment; however, due to the low overall incidence of these injuries, it should not be used as a blind screening tool for every child with blunt thoracic trauma.…”