Harmouche Majid, Slimani Eric Karim, Heraudeau Adeline, Verhoye Jean-Philippe
Department of Thoracic and Cardiovascular Surgery, Pontchaillou Hospital, Rennes, France.
Interact Cardiovasc Thorac Surg. 2013 Oct;17(4):739-40. doi: 10.1093/icvts/ivt307. Epub 2013 Jul 9.
Traumatic aortic injury represents 15% of motor vehicle related deaths with death occurring at the scene in 85% of the cases. Aortic disruptions usually occur at the isthmus in a transverse fashion with all three of the aortic layers being involved. Herein, we report the case of a 68-year old man with no prior medical history who was struck by a vehicle while riding his bicycle. The ruptured segment of aorta was resected circumferentially and interrupted horizontal mattress pledgeted prolene sutures were used to ensure full thickness aortic integrity of the proximal and distal aortic segments. The aorta was closed with a single-layer technique using 4/0 prolene suture. There were no postoperative complications and patient was discharged on Day 44. The case here discussed demonstrates a rare presentation of blunt aortic injury. The proximal ascending aorta is an unusual site of transection following blunt trauma with few reports in the literature. We were able to repair the aorta with direct suture, thus avoiding the use of artificial material.
创伤性主动脉损伤占机动车相关死亡人数的15%,其中85%的病例在现场死亡。主动脉破裂通常发生在峡部,呈横向撕裂,累及主动脉的所有三层结构。在此,我们报告一例68岁男性病例,该患者既往无病史,骑自行车时被车辆撞击。主动脉破裂段被环形切除,使用间断水平褥式带垫片的普理灵缝线确保近端和远端主动脉段的全层主动脉完整性。主动脉采用单层技术用4-0普理灵缝线缝合。术后无并发症,患者于第44天出院。本文讨论的病例展示了钝性主动脉损伤的罕见表现。钝性创伤后升主动脉近端是一个不寻常的横断部位,文献报道较少。我们能够直接缝合修复主动脉,从而避免使用人工材料。