| Total Arch Replacement for Blunt
Traumatic Aortic Injury Associated with Spine Fractures: A Case
Report |
(Department of Thoracic and Cardiovascular Surgery
and Emergency and Critical Care Medical Center, Niigata City
General Hospital, Niigata, Japan)
| Mayumi Shinonaga |
Hiroshi Kanazawa |
Satoshi Nakazawa |
| Toshimi Ujiie |
Yoshihiko Yamazaki |
Akitoshi Oda |
| Hidenori Kinoshita |
Yasuo Hirose |
|
|
An 80-year-old man was transferred
to our hospital because of blunt traumatic aortic arch injury
caused by a fall. Computed tomography (CT) revealed a pseudoaneurysm
and mediastinal hematoma around the aortic arch, right hemothorax,
left hemopneumothorax, lung contusion and spine fractures. His
hemodynamic condition was stable but he required mechanical ventilation
because of severe hypoxemia. Surgery was postponed until twelve
days after the injury, when his lung function improved and active
bleeding decreased. During surgery we found that the intimal
disruption extended to half of the circumference of the aortic
arch, and thus performed total arch replacement under deep hypothermic
circulatory arrest and selective cerebral perfusion. The patient
suffered respiratory failure and pneumonia postoperatively as
well as multiple cerebral infarctions. He was referred to a rehabilitation
center on postoperative day 130.
@Jpn. J. Cardiovasc. Surg. 30: 321-323 (2001) |
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