Ascending aortic injuries following blunt trauma. 2013

Xiumei Sun, and Jenny Hong, and Robert Lowery, and Steven Goldstein, and Zuyue Wang, and Joseph Lindsay, and Peter C Hill, and Paul J Corso
Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, District of Columbia.

BACKGROUND The diagnosis and the management of traumatic thoracic aortic injuries have undergone significant changes due to new technology and improved prehospital care. Most of the discussions have focused on descending aortic injuries. In this review, we discuss the recent management of ascending aortic injuries. METHODS We found 5 cohort studies on traumatic aortic injuries and 11 case reports describing ascending aortic injuries between 1998 to the present through Medline research. RESULTS Among case reports, 78.9% of cases were caused by motor vehicle accidents (MVA). 42.1% of patients underwent emergent open repair and the operative mortality was 12.5%. 36.8% underwent delayed repair. Associated injuries occurred in 84.2% of patients. Aortic valve injury was concurrent in 26.3% of patients. The incidence of ascending aortic injury ranged 1.9-20% in cohort studies. CONCLUSIONS Traumatic injuries to the ascending aorta are relatively uncommon among survivors following blunt trauma. Aortography has been replaced by computed tomography and echocardiography as a diagnostic tool. Open repair, either emergent or delayed, remains the treatment of choice.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004452 Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001011 Aorta The main trunk of the systemic arteries. Aortas
D001021 Aortic Valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Aortic Valves,Valve, Aortic,Valves, Aortic
D001022 Aortic Valve Insufficiency Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root). Aortic Incompetence,Aortic Regurgitation,Aortic Valve Incompetence,Regurgitation, Aortic Valve,Incompetence, Aortic,Incompetence, Aortic Valve,Insufficiency, Aortic Valve,Regurgitation, Aortic
D001027 Aortography Radiographic visualization of the aorta and its branches by injection of contrast media, using percutaneous puncture or catheterization procedures. Aortographies
D013898 Thoracic Injuries General or unspecified injuries to the chest area. Chest Injuries,Injuries, Chest,Injuries, Thoracic,Chest Injury,Injury, Chest,Injury, Thoracic,Thoracic Injury

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