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A Ten-Year Experience

Carlos A. Schmidt, MD; John G. Jacobson, MD

Arch Surg. 1984;119(11):1244-1246.

Abstract
• Between 1974 and 1983, 41 patients arrived alive at Loma Linda (Calif) University Medical Center after sustaining a traumatic disruption of the thoracic aorta. Four patients died during the resuscitation attempts and the 37 patients who survived underwent thoracotomy for attempted definitive repair. There were six hospital deaths (16.22%) among those who underwent definitive repair; associated injuries (mostly orthopedic and neurologic) were contributing factors. Four patients were discharged with spinal cord injuries, two were paraplegic on arrival at the hospital, and two became paraplegic postoperatively (surgical spinal cord injury, 5.41%). Most injuries were distal to the left subclavian artery (97.56%). Cardiopulmonary (left heart) bypass was gradually abandoned in favor of more simple techniques, including ventriculoaortic and aortoaortic heparinized shunts or a "clamp and sew" method. Experience has demonstrated that most traumatic aortic disruptions can be repaired safely by direct suture technique (without graft interposition) if accomplished during the acute episode.

(Arch Surg 1984;119:1244-1246)

Author Affiliations
From the Department of Thoracic and Cardiovascular Surgery, Loma Linda (Calif) University Medical Center.

Footnotes
Accepted for publication July 31, 1984.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 28, 1984.

Reprint requests to Department of Thoracic and Cardiovascular Surgery, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354 (Dr Schmidt).

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