Penetrating Aortic Root Injury

(Department of Radiology, Kansai Medical University, Hirakata, Japan, and Division of Cardiovascular Surgery, Ishikiriseiki Hospital, Higashiosaka, Japan)

Takanori Tokuda Noboru Tanigawa Hirofumi Fujii*
Motohiko Osako* Takeshi Ikuta* Satoshi Sawada
The patient was a 25-year-old man, who had been stabbed with a weapon siarilar to long ice pick. Thirty minutes later, he was admitted to our emergency center by ambulance. Anchocardiogram on admission revealed moderate pericardial effusion with normal heart function. Contrast medium enhanced computed tomography revealed that the weapon had entered from the left anterolateral chest wall and reached the posterior wall of the aortic root, approximately 1cm above the left coronary artery orifice, through the left lung. During examinations, he suddenly went into shock and emergency open pericardial drainage was performed immediately. Approximately 400ml of blood with a clot was removed from the pericardial cavity. After this procedure, there was no continuous bleeding. Subsequently, pseudoaneurysm developed at the aortic root injury site. Twenty seven days later, aortic surgery was performed. The injury site was resected and sutured directly, employing 4-0 polypropylene sutures with felt pledgets. He was discharged 14days after the operation without any complications.
  Jpn. J. Cardiovasc. Surg. 39:14-16(2010)

Keywords:traumatic aortic injury, traumatic ascending aortic injury, cardiac tamponade, pericardial drainage, stab wound