Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Unusual Presentation of a Penetrating Aortic Arch Injury

  • Vural, Fikret Sami (Department of Cardiothoracic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand) ;
  • Patel, Atul Kumar (Department of Cardiothoracic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand) ;
  • Mustafa, Kashif (Department of Cardiothoracic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand)
  • Received : 2016.10.25
  • Accepted : 2017.03.14
  • Published : 2017.08.05
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Abstract

A 27-year-old man was admitted with a penetrating injury at the mid-manubrium. Computed tomographic (CT) angiography showed a f illing def ect in the aortic arch. This was evaluated as a sign of injury and the patient underwent an emergency operation. No active bleeding or clot was f ound in the mediastinum during the operation. The laceration point was between the innominate and the left carotid artery posteriorly. The injury was approached using hypothermic circulatory arrest. Aortotomy and exploration showed a 2-cm-long full-thickness aortic injury with an overlying clot. A filling defect on angiography as a sign of a penetrating arch injury has never been reported previously, but was the main pathological finding on CT angiography in our case. The aorta is a high-pressure system and injuries to it should be treated aggressively.

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References

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