Espinoza HJD, Nina VO, Venegas GU, Marroquín RR, Villarreal RCB, Molina E

Language: Spanish
References: 12
Page: 47-50
PDF size: 585.71 Kb.

ABSTRACT

Background: Aortic injury due to blunt trauma and deceleration, is the second most common cause of death after severe traffic accidents. Aortic rupture can occur at any level of the thoracic aorta and much less frequently in the abdominal aorta. In this work we report two cases of succesfully treated rupture of the thoracic aorta.
Material and methods: Both cases were female patients who suffered a car accident where the deceleration was the main cause. They suffered fractures of the limbs that were subsequently taken care of. In the case 1 the diagnosis was delayed because of hemoperitoneum required surgical exploration; patient entered asystole on two occasions that responded to resuscitation. In case 2, large-vessel injury was suspected 24 hours after. The final diagnosis was made by angiography; which demonstrated aortic rupture at the isthmus.
Results: Left posterolateral thoracotomy confirms the type of lesion to the aortic isthmus in both cases. Thoracic aorta continuity was achieved with Dacron graft under precoagulated circulatory support, using left atrium-femoral bypass without complications. Early and late evolution was uneventful.
Conclusions: Aortic rupture is common in slowing traffic accidents. The use of left bypass is a safe method for the treatment of these lesions. Especially in health care facilities where routine endovascular surgery is uncommon.

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