Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Delayed Surgical Management of Traumatic Pseudoaneurysm of the Ascending Aorta in Multiple Trauma

  • Ma, Dae Sung (Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center) ;
  • Kim, Sung Jin (Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center) ;
  • Joo, Seok (Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center) ;
  • Hyun, Sung Youl (Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center) ;
  • Jeon, Yang Bin (Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center)
  • Received : 2017.12.14
  • Accepted : 2018.02.05
  • Published : 2018.04.30
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Abstract

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

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References

  1. Jamieson WR, Janusz MT, Gudas VM, Burr LH, Fradet GJ, Henderson C. Traumatic rupture of the thoracic aorta:third decade of experience. Am J Surg 2002;183:571-5. https://doi.org/10.1016/S0002-9610(02)00851-6
  2. Burkhart HM, Gomez GA, Jacobson LE, Pless JE, Broadie TA. Fatal blunt aortic injuries: a review of 242 autopsy cases. J Trauma 2001;50:113-5. https://doi.org/10.1097/00005373-200101000-00020
  3. Symbas PN, Tyras DH, Ware RE, Diorio DA. Traumatic rupture of the aorta. Ann Surg 1973;178:6-12. https://doi.org/10.1097/00000658-197307000-00002
  4. Kato N, Dake MD, Miller DC, Semba CP, Mitchell RS, Razavi MK, et al. Traumatic thoracic aortic aneurysm:treatment with endovascular stent-graf ts. Radiology 1997;205:657-62. https://doi.org/10.1148/radiology.205.3.9393517
  5. Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 2008;64:561-70; discussion 570-1. https://doi.org/10.1097/TA.0b013e3181641bb3
  6. Nienaber CA, Sakalihasan N, Clough RE, Aboukoura M, Mancuso E, Yeh JS, et al. Thoracic endovascular aortic repair (TEVAR) in proximal (type A) aortic dissection:Ready for a broader application? J Thorac Cardiovasc Surg 2017;153:S3-11. https://doi.org/10.1016/j.jtcvs.2016.07.078
  7. Rabin J, Harris DG, Crews GA, Ho M, Taylor BS, Sarkar R, et al. Early aortic repair worsens concurrent traumatic brain injury. Ann Thorac Surg 2014;98:46-51; discussion 51-2. https://doi.org/10.1016/j.athoracsur.2014.04.025