Tegner Y, Bergdahl L, Ekeström S
Acta Chir Scand. 1984;150(8):635-8.
Fourteen cases of injury to the thoracic aorta treated in 1959-1981 are reviewed. Acute rupture was present in nine patients and chronic post-traumatic aneurysm in five. Most of the patients had other, associated injuries, and physical signs of the aortic injury were often scanty. Widening of the mediastinum was the most common roentgenographic finding. All the aortic ruptures were localized to the isthmus. One patient declined surgery. Another died on the operating table just before surgery was started. A third patient died peroperatively from severe bleeding when the aneurysm was dissected free. All of the other 11 patients survived operation without major complications. At follow-up (mean 10 years), ten patients were alive and well and one had died of unrelated cause. The most recent operations were performed with the aid of a TDMAC (Gott) shunt, which makes aortic repair safe and simple. Because aortic trauma often is accompanied by other, severe injuries which make transportation of the patient risky, and so as not to delay operation, the aortic lesions should be repaired at general surgical units. If necessary, a thoracic surgeon should be brought to the hospital.
回顾了1959年至1981年期间治疗的14例胸主动脉损伤病例。9例患者为急性破裂，5例为慢性创伤后动脉瘤。大多数患者还伴有其他损伤，主动脉损伤的体征往往较少。纵隔增宽是最常见的X线表现。所有主动脉破裂均局限于峡部。1例患者拒绝手术。另1例患者在手术即将开始前死于手术台上。第3例患者在动脉瘤游离切除时因严重出血死于术中。其他11例患者均手术存活，无重大并发症。随访（平均10年）时，10例患者存活且情况良好，1例死于无关原因。最近的手术借助TDMAC（戈特）分流器进行，这使得主动脉修复安全且简单。由于主动脉创伤常伴有其他严重损伤，使患者转运存在风险，且为不延误手术，主动脉病变应在普通外科单位进行修复。如有必要，应请胸外科医生到医院。
