Aortic Arch Rupture due to Compression Injury of the Thorax: A case report / 대한흉부외과학회지

ABSTRACT

Traumatic rupture of the thoracic aorta is the second most common cause of death from motor vehicle accidents after head injury. About 85% of these patients do not survive to reach the hospital. The most common mechanism for this is deceleration injury, as occurs in a high speed motor vehicle accident. The aortic isthmus is the site of disruption for about 95% of all blunt thoracic aortic injuries. Another mechanism is crush injury which causes compression of the aorta between the displaced sternal body or manubrium and the thoracic vertebral column. These forces tear the inner layer of the aortic wall at an unusual location. We report here on a case of aortic arch dissection where the injury clearly occurred due to a crush injury and not because of deceleration. The surgical repair was delayed for 10 days after administering intensive medical therapy. The ascending aorta and aortic arch were replaced with an artificial graft with the patient under circulatory arrest and cerebral protection.