Total Arch Replacement for Blunt Traumatic Aortic Injury Associated with Spine Fractures: A Case Report

(Department of Thoracic and Cardiovascular Surgery and Emergency and Critical Care Medical Center–, Niigata City General Hospital, Niigata, Japan)

Mayumi Shinonaga Hiroshi Kanazawa Satoshi Nakazawa
Toshimi Ujiie Yoshihiko Yamazaki– Akitoshi Oda–
Hidenori Kinoshita– Yasuo Hirose–
An 80-year-old man was transferred to our hospital because of blunt traumatic aortic arch injury caused by a fall. Computed tomography (CT) revealed a pseudoaneurysm and mediastinal hematoma around the aortic arch, right hemothorax, left hemopneumothorax, lung contusion and spine fractures. His hemodynamic condition was stable but he required mechanical ventilation because of severe hypoxemia. Surgery was postponed until twelve days after the injury, when his lung function improved and active bleeding decreased. During surgery we found that the intimal disruption extended to half of the circumference of the aortic arch, and thus performed total arch replacement under deep hypothermic circulatory arrest and selective cerebral perfusion. The patient suffered respiratory failure and pneumonia postoperatively as well as multiple cerebral infarctions. He was referred to a rehabilitation center on postoperative day 130.
@Jpn. J. Cardiovasc. Surg. 30: 321-323 (2001)