Abstract
Techniques have undergone much change since the first successful repair of an acute traumatic rupture of the descending thoracic aorta was performed by Klassen at our hospital in 1959. It is interesting that we are returning to the techniques which worked so well in that case. Using this approach, which involves virtual elimination of the use of cardiopulmonary bypass, and evaluating each patient individually for the use of a shunt, we have reduced our mortality rate from 61% (8 deaths among 13 patients) during the period 1959–1974, to 6% (1 death among 17 patients) in the last 5 years. We believe that these data confirm the validity of this approach in the management of acute blunt descending thoracic aortic rupture. Prevention of spinal cord ischemia has become the primary concern for continuing clinical and laboratory investigation.
Résumé
Les techniques de réparation de ruptures traumatiques aigües de l'aorte thoracique descendante ont subi de nombreuses modifications depuis la première opération réussie par Klassen dans notre hôpital en 1959. Il est intéressant de constater qu'on revient progressivement à la technique appliquée avec succès dans ce premier cas et qui n'utilise presque jamais la circulation extracorporelle. Nous l'avons employée, en analysant soigneusement chaque cas en vue de l'utilisation d'un bypass. Nous avons ainsi réduit notre mortalité de 61% entre 1959 et 1974 (8 décès sur 13 cas) à 6% pour les 5 dernières années (l décès sur 17 cas). Ces résultats confirment la valeur de cette méthode de traitement des ruptures aigües par traumatisme fermé de l'aorte descendante. La clinique et les examens de laboratoire doivent s'intéresser surtout à la prévention des ischémies médullaires.
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Williams, T.E., Vasko, J.S., Kakos, G.S. et al. Treatment of acute and chronic traumatic rupture of the descending thoracic aorta. World J. Surg. 4, 545–550 (1980). https://doi.org/10.1007/BF02401625
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DOI: https://doi.org/10.1007/BF02401625