TRAUMATIC AORTIC TRANSECTION

Abstract

Blunt traumatic aortic transection (TAT) is an uncommon injury in clinical practice and is associated with high rates of morbidity and mortality. The approach to patients with such an injury is controversial, with specific regard to the most effective diagnostic tools, timing of surgical intervention, and mechanisms of spinal cord protection. Chest X-ray with the widening of the mediastinum is unreliable as a diagnostic tool. Contrast-enhanced helical CT scan has replaced the traditional angiography as the screening diagnostic tool of choice. Active augmentation of the distal perfusion pressure during cross-clamping offers the best protection against the development of paraplegia during open surgical repair. Endovascular stenting offers a minimally invasive method of treatment, but the long-term durability of the endovascular stent is still unknown.