Case Study
Delayed surgery for type A aortic dissection caused by blunt trauma
Asian Cardiovascular & Thoracic Annals 2015, Vol. 23(2) 206–208 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313501164 aan.sagepub.com
Shinya Takahashi, Naomichi Uchida, Taiichi Takasaki and Taijiro Sueda
Abstract We describe a rare case of delayed surgery for blunt ascending aortic injury. A 77-year-old man was injured in a traffic accident. He lost consciousness and suffered severe blunt trauma to the chest. Computed tomography showed multiple head and chest injuries and acute Stanford type A aortic dissection. The operation was postponed because he was hemodynamically stable and his risk of surgical death was increased due to his other injuries. Serial computed tomography showed growth of the aortic lesion, and aortic surgery was successfully performed 11 months after admission to the hospital. The postoperative course was uneventful.
Keywords Accidents, traffic, aneurysm, dissecting, aortic aneurysm, thoracic, wounds, nonpenetrating
Introduction Aortic injury after blunt chest trauma often occurs in the isthmus of the aortic arch, but rarely in the ascending aorta. Acute Stanford type A aortic dissection is life-threatening and requires emergency repair in most cases. We describe a case of successful delayed elective repair of a dissecting aneurysm in the ascending aorta caused by blunt trauma.
Case report A 77-year-old man was injured in a traffic accident and transferred to our hospital. He lost consciousness but retained flexor responses to pain. Percutaneous oxygen saturation was 80%. Computed tomography (CT) showed subarachnoid hemorrhage, multiple rib and sternal fractures, bilateral pneumothorax and hemothorax, mediastinal and subcutaneous emphysema, and acute aortic dissection. The aortic dissection extended from the sinus of Valsalva to the origin of the brachiocephalic artery; there was no neck branch vessel dissection or aortic valve regurgitation (Figure 1a–c). The aortic operation was postponed because he was hemodynamically stable and his risk of surgical death was increased due to his associated injuries. A beta blocker and calcium channel
antagonist were administrated to keep his systolic blood pressure
Delayed surgery for type A aortic dissection caused by blunt trauma
Asian Cardiovascular & Thoracic Annals 2015, Vol. 23(2) 206–208 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313501164 aan.sagepub.com
Shinya Takahashi, Naomichi Uchida, Taiichi Takasaki and Taijiro Sueda
Abstract We describe a rare case of delayed surgery for blunt ascending aortic injury. A 77-year-old man was injured in a traffic accident. He lost consciousness and suffered severe blunt trauma to the chest. Computed tomography showed multiple head and chest injuries and acute Stanford type A aortic dissection. The operation was postponed because he was hemodynamically stable and his risk of surgical death was increased due to his other injuries. Serial computed tomography showed growth of the aortic lesion, and aortic surgery was successfully performed 11 months after admission to the hospital. The postoperative course was uneventful.
Keywords Accidents, traffic, aneurysm, dissecting, aortic aneurysm, thoracic, wounds, nonpenetrating
Introduction Aortic injury after blunt chest trauma often occurs in the isthmus of the aortic arch, but rarely in the ascending aorta. Acute Stanford type A aortic dissection is life-threatening and requires emergency repair in most cases. We describe a case of successful delayed elective repair of a dissecting aneurysm in the ascending aorta caused by blunt trauma.
Case report A 77-year-old man was injured in a traffic accident and transferred to our hospital. He lost consciousness but retained flexor responses to pain. Percutaneous oxygen saturation was 80%. Computed tomography (CT) showed subarachnoid hemorrhage, multiple rib and sternal fractures, bilateral pneumothorax and hemothorax, mediastinal and subcutaneous emphysema, and acute aortic dissection. The aortic dissection extended from the sinus of Valsalva to the origin of the brachiocephalic artery; there was no neck branch vessel dissection or aortic valve regurgitation (Figure 1a–c). The aortic operation was postponed because he was hemodynamically stable and his risk of surgical death was increased due to his associated injuries. A beta blocker and calcium channel
antagonist were administrated to keep his systolic blood pressure
