Hybrid surgery for blunt aortic injury with rupture: a case report

J Cardiothorac Surg. 2022 Dec 9;17(1):301. doi: 10.1186/s13019-022-02060-w.

Abstract

Background: Blunt thoracic aortic injury is one of the most lethal traumatic injuries. Ruptured cases often result in cardiac arrest before arrival at the hospital, and survival is rare.

Case presentation: A female patient in her 30 s was struck by an automobile while she was walking across an intersection. She was in a state of shock when emergency services arrived and was in cardiac arrest shortly after arriving at the hospital. A left anterolateral thoracotomy revealed a massive hemothorax secondary to thoracic aortic rupture. In addition, the patient had multiple traumas, including maxillary, pelvic, and lumbar burst fractures. We attempted to directly suture the aortic lesion; however, the increasing blood pressure caused the suture to break. We used a thoracic stent graft while ensuring permissive hypotension. Her postoperative prognosis was positive, and she was transferred to another hospital 85 days later.

Conclusions: We successfully performed a hybrid surgery combining thoracotomy and endovascular repair for this emergency case of blunt thoracic aortic injury with rupture.

Keywords: Blunt thoracic aortic injury; Hybrid surgery; Thoracic endovascular aortic repair.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Thoracic / injuries
  • Aorta, Thoracic / surgery
  • Aortic Rupture* / complications
  • Aortic Rupture* / surgery
  • Blood Vessel Prosthesis Implantation*
  • Endovascular Procedures*
  • Female
  • Heart Arrest* / surgery
  • Humans
  • Stents
  • Thoracic Injuries* / complications
  • Treatment Outcome
  • Vascular System Injuries* / complications
  • Wounds, Nonpenetrating* / complications
  • Wounds, Nonpenetrating* / surgery