Operative technique, paraplegia, and mortality after blunt traumatic aortic injury

Archives of Surgery
Gary M HochheiserJeremy R Morton

Abstract

The use of mechanical circulatory support (MCS) during repair of traumatic aortic injuries is associated with a decreased incidence of postoperative paraplegia and mortality. Historical cohort study with contemporaneous but nonrandomized controls in a tertiary care hospital from July 1, 1988, through December 31, 1999. Consecutive cases undergoing operation for traumatic aortic injuries. Use of MCS (with or without systemic heparinization) determined by surgeon preference. Incidence of postoperative paraplegia and mortality. Twenty-two patients underwent repair of traumatic aortic injuries using MCS, resulting in no paraplegia but 4 deaths, 3 of them from cerebral ischemia. Thirteen patients had their traumatic aortic injuries repaired using a "clamp-and-sew" or passive shunt technique with no deaths but paraplegia in 2. Compared with an earlier report from our group from January 1, 1975, through June 30, 1988, the annual incidence of traumatic aortic injuries has decreased, whereas the age of patients and proportion of operations using MCS have increased. A review of the recent literature on traumatic aortic injuries reveals an average postoperative paraplegia incidence of 1% with MCS and 16% without MCS. Overall mortality is ...Continue Reading

Citations

Oct 17, 2008·The New England Journal of Medicine·David G NeschisBartley P Griffith
Jul 29, 2008·Journal of Vascular and Interventional Radiology : JVIR·Eric K HofferJohn M Gemery
May 18, 2010·Journal of Vascular Surgery·Michael Zhen-Yu TongThomas L Forbes
Nov 3, 2010·Journal of Vascular Surgery·Mohammad Hassan MuradRonald M Fairman
Jun 6, 2006·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A L TambyrajaR T A Chalmers
May 7, 2004·The Journal of Trauma·Michael C OttThomas L Forbes

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