HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Roques, X. Articles by Baudet, E. Search for Related Content PubMed PubMed Citation Articles by Roques, X. Articles by Baudet, E. Related Collections Great vessels

Eur J Cardiothorac Surg 2003;23:46-49
© 2003 Elsevier Science NL

Surgery of chronic traumatic aneurysm of the aortic isthmus: benefit of direct suture

Department of Cardiovascular and Paediatric Cardiac Surgery, Bordeaux Heart University Hospital, Hôpital Haut-Lévêque, F-33604 Pessac, France

Received 18 September 2001; received in revised form 3 October 2002; accepted 11 October 2002.

* Corresponding author. Tel.: +33-5-5655-6456; fax: +33-5-5655-6452
e-mail: xavier.roques{at}chu-bordeaux.fr

Objective: Retrospective evaluation of long term results after direct suture repair of chronic traumatic aneurysm of the aortic isthmus. Methods: From March 1979 to June 1998, a total of 19 patients with chronic traumatic aneurysm of the aortic isthmus were operated on, among whom 12 (63%) underwent direct suture. These 12 patients (age ranging from 19 to 68 years; mean 34.2 years) constitute the subject of this study. All but one suffered traffic accidents. Mean delay between trauma and surgery was 4 years (range 3 months to 12 years). All patients underwent a left posterolateral thoracotomy through the fourth intercostal space. Extracorporeal circulation for spinal cord protection was installed in six patients (five ilio-iliac shunts, one atrio-iliac shunt). Aortic rupture was partial in five and circumferential in seven patients. The mean clamping time was 25 min. The absence of loss of aortic substance and a careful mobilization of the aorta made the repair by direct suture easier; this technique could thus be achieved in 63.2% of all 19 patients operated on of chronic traumatic aneurysm within the same period. Results: There was no in-hospital death and no postoperative paraplegia. With a median follow-up of 15 years 3 months (ranging from 22 to 10 years), there were no late complications. Chest X-ray was normal in all patients; eight of them underwent a control angiography between 18 and 72 postoperative months; all these angiographies but one (20% stenosis without gradient) demonstrated a normal appearance of aortic isthmus. Conclusion: Direct suture for repair of chronic traumatic thoracic aneurysm is a safe procedure: long-term outcome was excellent and the complications observed with prosthetic grafts or with aortic endoprosthetic stent-grafts were avoided.

Key Words: Descending aorta • Chronic traumatic aneurysm