Abstract
Blunt traumatic transection of the aorta (BTTA) is associated with a very high mortality rate. Most victims die at the time of the injury. A review of surgically treated BTTA in Ireland between 1989 and 2002 was performed. The accident files of all road traffic deaths during 2001 and incidence data on national road traffic deaths for the study period were also reviewed. There were 30 acute and 9 chronic BTTA. Of the 30 acute transections, 29 were due to road traffic accidents (RTA) and one a crush injury. Major associated injuries included head injuries (7), fractures (13) with paraplegia in 2 and abdominal injuries requiring surgery in 4. There were 3 (10%) hospital deaths (2 arrested on induction) and no cases of postoperative paraplegia. In 2001, 18.4% of RTA victims had a BTTA on post-mortem and 8.7% of these survived to hospitalisation. 60% of BTTA victims surviving to hospitalisation have undergone successful repair. BTTA must be considered following blunt trauma and should be out-ruled by present scanning techniques.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Williams, J.S., Graff, J.A., Uku, J.M. and Steinig, J.P., Aortic injury in vehicular trauma, Ann Thorac Surg, 57, 1994, 726–730.
McGwin, G., Reiff, D.A., Moran, S.G. and Rue, L.W., Incidence and characteristics of motor vehicle collision-related blunt thoracic aortic injury according to age. J Trauma 52, 2002, 859–866.
Beel, T. and Harwood, A.L., Traumatic rupture of the thoracic aorta. Ann Emerg Med 9, 1980, 483–486.
Fabian, T.C., Davis, K.A. and Gavant, M.L., Prospective study of blunt aortic injury: helical CT is diagnostic and antihypertensive therapy reduces rupture. Ann Surg 227, 1998, 666–676.
Hill, D.A., Duflou, J. and Delaney, L.M., Blunt traumatic rupture of the thoracic aorta: an epidemiological perspective. J R Coll Surg Edin 41, 1996, 84–87.
Fabian, T.C., Richardson, J.D. and Croce, M.A., Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma. J Trauma 42, 1997, 374–380.
Hossack, D.W., The pattern of injuries received by 500 drivers and passengers Killed in road traffic accidents. Med J Aust 2, 1972, 193–195.
Sevitt, S., Fatal road accidents in Birmingham:times to death and their causes. Injury 4, 1972, 281–293.
Shkrum, M., McClafferty, K., Green, R., Nowak, E. and Young, J., Mechanisms of aortic injury in fatalities occuring in motor vehicle collisions. J Forensic Sci 44, 1999, 44–56.
Parmley, L.F., Mattingly, T.W., Manion, W.C. and Jahnke, E.J. Jr., Nonpenetrating traumatic injury of the aorta. Circulation 1958;17:1086–1101.
Pate, J.W., Fabian, T.C. and Walker, W., Traumatic rupture of the aortic isthmus: an emergency? World J Surg 19, 1995, 119–125.
Sevitt, S., Traumatic ruptures of the aorta: a clinico-pathological study. Injury 8, 1977, 159–173.
Crass, J.R., Cohen, A.M., Motta, A.O., Tomashefski, J.F., Jr. and Wiesen, E.J., A proposed new mechanism of traumatic aortic rupture: the osseous pinch. Radiology 176, 1990, 645–649.
Javadpour, H., O'Toole, J.J., McEniff, J.N., Luke, D.A. and Young, V.K., Traumatic aortic transection: evidence for the osseous pinch mechanism. Ann Thorac Surg 73, 2002, 951–953.
Answini, G.A., Sturdevant, M., Sing, R. and Jacobs, D., Blunt Traumatic Rupture of the Thoracic Aorta: A report of an Unusual Mechanism of Injury. Am J Emerg Med 19, 2001, 579–582.
Gammie, J.S., Ashish, S.S., Hattler, B.G., Kormos, R.L., Peitzman, A.B. and Griffith, B.P., Traumatice Aortic Rupture: Diagnosis and Management. Ann Thorac Surg 66, 1998, 1295–1300.
Sweeney, M.S., Young, D.J., Frazier, O.H., Adams, P.R., Kapusta, M.O. and Macris, M.P., Traumatic aortic transections: eight-year experience with the "clamp-sew" technique. Ann Thorac Surg 64, 1997, 384–387.
Exadaktylos, A.K., Sclabas, G., Scmid, S.W., Schaller, B. and Zimmerman, H., Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograp? J Trauma 51, 2001, 1173–1176.
Pate, J.W., Is traumatic rupture of the aorta misunderstood? Ann Thorac Surg 57, 1994, 530–531.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer
About this paper
Cite this paper
Naughton, P.A., Nölke, L., Shaw, C., Healy, D.G., O'Donnell, A., Wood, A.E. (2005). A National Review of Surgically Treated Blunt Traumatic Thoracic Aortic Transections. In: Gilchrist, M.D. (eds) IUTAM Symposium on Impact Biomechanics: From Fundamental Insights to Applications. Solid Mechanics and Its Applications, vol 124. Springer, Dordrecht. https://doi.org/10.1007/1-4020-3796-1_33
Download citation
DOI: https://doi.org/10.1007/1-4020-3796-1_33
Publisher Name: Springer, Dordrecht
Print ISBN: 978-1-4020-3795-5
Online ISBN: 978-1-4020-3796-2
eBook Packages: EngineeringEngineering (R0)