naa a22 4500 51072843X CHVBK 20180411082943.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s11748-012-0197-x doi (NATIONALLICENCE)springer-10.1007/s11748-012-0197-x Surgical management of traumatic rupture of aortic isthmus: a 25-year experience [Elektronische Daten] [Seyed Mirhosseini, Shadi Asadollahi, Mohammad Fakhri] Objective: Traumatic rupture of the thoracic aorta is a surgical emergency with a high mortality rate. This condition requires prompt diagnosis and expeditious evaluation to improve patient survival. The aim of this study is to evaluate the outcomes of early and late management of traumatic rupture of aortic isthmus in patients with blunt thoracic trauma. Methods: Between February 1980 and June 2005, 64 patients sustained blunt thoracic trauma underwent open surgical repair for traumatic rupture of the aortic isthmus (7 women, 57 men, and mean age 38±14.3years). Clinical signs of diagnostic principles in our series of patients were: chest pain and dyspnea (48.5%), hemoptysis (23.5%), and hypotension (15.5%). All patients underwent a left posterolateral thoracotomy through the fourth or fifth intercostal space or median sternotomy. Extracorporeal circulation for spinal cord protection was installed in all patients. Results: Of the 64 patients identified over the 25-year study period, 15 (23.5%) underwent direct suture, 48 (75%) underwent interposition graft repair, and 1 (1.5%) experienced patch aortoplasty repair. The overall hospital mortality rate for the entire patient was 3% due to multiple organ failure and myocardial infarction. No paraplegia occurred postoperatively. Three patients died during the follow-up period, two from myocardial infarction, and one from acquired immunodeficiency syndrome. Conclusions: Traumatic aortic rupture remains a potentially lethal injury and an ongoing therapeutic challenge. Open surgical technique to repair the traumatic rupture of aorta is a safe procedure: postoperative outcome was excellent and the complications observed that were with aortic endoprosthetic stent-grafts were avoided. The Japanese Association for Thoracic Surgery, 2012 Aortic rupture nationallicence Surgical repair nationallicence Trauma nationallicence Late repair nationallicence Mirhosseini Seyed Department of Cardiovascular Surgery, Pitié-Salpêtrière University Hospital, Paris Curie University, Paris, France aut Asadollahi Shadi School of Medicines, Shahid Beheshti University of Medical Science, Tehran, Iran aut Fakhri Mohammad Chronic Lung Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad St, Shahid Bahonar Ave, Tehran, Iran aut General Thoracic and Cardiovascular Surgery Springer Japan 61/4(2013-04-01), 212-217 1863-6705 61:4<212 2013 61 11748 https://doi.org/10.1007/s11748-012-0197-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0197-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mirhosseini Seyed Department of Cardiovascular Surgery, Pitié-Salpêtrière University Hospital, Paris Curie University, Paris, France aut NATIONALLICENCE 700 1- Asadollahi Shadi School of Medicines, Shahid Beheshti University of Medical Science, Tehran, Iran aut NATIONALLICENCE 700 1- Fakhri Mohammad Chronic Lung Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Darabad St, Shahid Bahonar Ave, Tehran, Iran aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/4(2013-04-01), 212-217 1863-6705 61:4<212 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer