Disruption of aortic arch branches due to nonpenetrating chest trauma.

From 1967 through 1979, six patients sustained non-penetrating chest trauma with disruption of the Innominate, carotid, and subclavian arteries. Diagnosis was established in each case by aortography. Two patients with subclavian artery injuries underwent exploration through lateral thoracotomies, and three patients underwent sternotomy for innominate artery disruptions. A cervical approach was used for a common carotid artery disruption. One patient had innominate and left common carotid artery disruption. Two patients with subclavian injuries had associated bronchial disruptions. Cardiopulmonary bypass was used in one patient and should be available in all cases. One patient died with multiple vessel and bronchial disruption. A variety of repairs were used, varying from simple oversewing of the subclavian artery to elaborate graft replacement of the innominate and left common carotid arteries.