Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2019

Open Access 01-12-2019 | Aortic Rupture | Case report

Hybrid treatment of an unusual traumatic aortic arch rupture with pseudoaneurysm: a case report

Authors: Shoujun Tang, Shengjie Tang, Li Yu, Yongheng Zhang, Haining Zhou

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Login to get access

Abstract

Background

Traumatic aortic arch rupture with pseudoaneurysm is a rare high fatal injury. Thoracic endovascular aortic repair(TEVAR) is widely used in the treatment of aortic diseases. However a unified traumatic aortic injury risk stratification tool still lacks. The patients’ disease assessment and operation method still rely on the doctors’ subjective anticipation of disease and surgical results.

Case presentation

A 31-year-old male presented with chest pain and hoarseness of recent onset. Imageological examination showed aortic rupture with mediastinal pseudoaneurysm in Zone 1. Debranching + TEVAR hybrid operation was considered: Using artificial blood vessels rebuild the arch branches, the covered stent was placed in aortic arch for endovascular repair via femoral artery. The follow-up was good in postoperative 7d, 1 year and > 2 years.

Conclusion

The traumatic aortic arch rupture with pseudoaneurysm treated by Debranching+TEVAR hybrid operation is feasible. The short-term and medium-term follow-up results are satisfactory. For traumatic aortic arch injury, hybrid operation is recommended to reduce the risk of cardiopulmonary bypass and deep hypothermia circulatory arrest under no open operation conditions or emergency situation.
Literature
1.
go back to reference Fox N, Schwartz D, Salazar JH. Evaluation and management of blunt traumatic aortic injury. J Trauma Nurs. 2015;22:99–110.CrossRef Fox N, Schwartz D, Salazar JH. Evaluation and management of blunt traumatic aortic injury. J Trauma Nurs. 2015;22:99–110.CrossRef
2.
go back to reference Parmeley LF, Mattingly TW, Manion WC, Jahnke EJ. Nonpenetrating traumatic injury of the aorta. Circulation. 1958;17:1086–101.CrossRef Parmeley LF, Mattingly TW, Manion WC, Jahnke EJ. Nonpenetrating traumatic injury of the aorta. Circulation. 1958;17:1086–101.CrossRef
3.
go back to reference Riesenman P, Tamaddon HS, Farber MA. Surgical bypass procedures to facilitate endovascular repair of aortic arch pathology. J Cardiovasc Surg. 2008;49:461–9. Riesenman P, Tamaddon HS, Farber MA. Surgical bypass procedures to facilitate endovascular repair of aortic arch pathology. J Cardiovasc Surg. 2008;49:461–9.
4.
go back to reference Shackford SR, Dunne CE, Karmy-Jones R, et al. The evolution of care improves outcome in blunt thoracic aortic injury: a Western trauma association multicenter study. J Trauma Acute Care Surg. 2017;83:1006–13.CrossRef Shackford SR, Dunne CE, Karmy-Jones R, et al. The evolution of care improves outcome in blunt thoracic aortic injury: a Western trauma association multicenter study. J Trauma Acute Care Surg. 2017;83:1006–13.CrossRef
5.
go back to reference Demetriades D, Velmahos GC, Scalea TM, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma multicenter study. J Trauma. 2008;64:561–70 discussion 570-1.CrossRef Demetriades D, Velmahos GC, Scalea TM, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma multicenter study. J Trauma. 2008;64:561–70 discussion 570-1.CrossRef
Metadata
Title
Hybrid treatment of an unusual traumatic aortic arch rupture with pseudoaneurysm: a case report
Authors
Shoujun Tang
Shengjie Tang
Li Yu
Yongheng Zhang
Haining Zhou
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-019-0896-9

Other articles of this Issue 1/2019

Journal of Cardiothoracic Surgery 1/2019 Go to the issue