Parameters for successful nonoperative management of traumatic aortic injury

The Journal of Thoracic and Cardiovascular Surgery
Joseph RabinBartley P Griffith

Abstract

Blunt traumatic aortic injury is associated with significant mortality, and increased computed tomography use identifies injuries not previously detected. This study sought to define parameters identifying patients who can benefit from medical management. We reviewed 4.5 years of blunt traumatic aortic injuries. Injury was classified as grade I (intimal flap or intramural hematoma), II (small pseudoaneurysm <50% circumference), III (large pseudoaneurysm >50% circumference), and IV (rupture/transection). Secondary signs of injury included pseudocoarctation, extensive mediastinal hematoma, and large left hemothorax. Follow-up, including computed tomography, was reviewed. We identified 97 patients: 31 grade I, 35 grade II, 24 grade III, and 7 grade IV; 67(69%) male; mean age 47 ± 18.8 years, mean Injury Severity Score 38.8 ± 14.6; overall survival 76 (78.4%). Secondary signs of injury were found in 30 patients. Overall, 52 (53.6%) underwent repair, 45 undergoing thoracic endovascular aortic repair, with 2 (2.22%) procedure-related deaths, and 7 undergoing open repair. Five patients undergoing thoracic endovascular aortic repair required 7 additional procedures. In 45 medically managed patients, there were 14 deaths (31%), all seco...Continue Reading

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Citations

May 27, 2014·The Annals of Thoracic Surgery·Joseph RabinRobert S Crawford
Jul 16, 2014·Annals of Vascular Surgery·Donald G HarrisRobert S Crawford
Nov 18, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Takashi TagamiHideo Yasunaga
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Jul 1, 2015·Diagnostic and Interventional Imaging·F Z MokraneH Rousseau
Sep 10, 2014·Journal of Vascular Surgery·Donald G HarrisRobert S Crawford
Mar 2, 2016·Journal of Vascular Surgery·Gerald R FortunaAli Azizzadeh
Oct 21, 2016·Journal of Vascular Surgery·Donald G HarrisRobert S Crawford
Jun 3, 2016·Journal of Surgical Case Reports·John Alfred Carr
Jun 7, 2016·Annals of Vascular Surgery·Donald G HarrisRobert S Crawford
Jan 28, 2017·The Journal of Trauma and Acute Care Surgery·Megan BrennerThomas Scalea
Sep 20, 2018·VASA. Zeitschrift für Gefässkrankheiten·Elizabeth L ChouMatthew J Eagleton
May 5, 2017·The Journal of Cardiovascular Surgery·Cornelis P van der ZeeMaarten J van der Laan
Mar 12, 2019·The Journal of Cardiovascular Surgery·Anna N Romagnoli, Joseph Dubose
Mar 11, 2015·The Journal of Trauma and Acute Care Surgery·Joseph J DuBoseUNKNOWN Aortic Trauma Foundation
Mar 10, 2016·The Journal of Trauma and Acute Care Surgery·Matthew R SmedsAhsan T Ali
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Jan 13, 2017·Cardiovascular and Interventional Radiology·Prashant NagpalAshish Khandelwal
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Sep 24, 2020·The Journal of Cardiovascular Surgery·Ilenia D'alessioSanti Trimarchi
Jan 18, 2020·Journal of Vascular and Interventional Radiology : JVIR·Siddharth A PadiaSue E Hanks
Oct 17, 2020·Vascular and Endovascular Surgery·Daniel ChengPaul J Chestovich
Dec 29, 2020·Annals of Vascular Surgery·Elina QuirogaNiten Singh
Mar 30, 2019·Journal of Vascular Surgery·Elina QuirogaNiten Singh
May 28, 2019·Journal of Vascular Surgery·Jean Jacob-BrassardCharles de Mestral

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