[A case of total arch replacement for traumatic aortic arch rupture].

We report a case of aortic arch rupture due to blunt chest trauma. A 64-year-old woman was crushed under a wood when she was working. On her arrival to our hospital, she was in shock state due to cardiac tamponade. Her chest roentogenogram showed fracture of her right-sided ribs and mediastinal widening. Her chest CT revealed hematoma around the aortic arch. Her transesophageal echography (TEE) demonstrated an intimal flap in the aortic arch. An emergency operation was performed immediately under the hypothermic circulatory arrest with a selective cerebral perfusion. As the intimal disruption was found to be extended to three fourths of the circumference of aortic arch, total arch replacement was performed. In this case, the TEE was useful for the immediate diagnosis of the aortic rupture. This was the first successful case of total arch replacement for a traumatic arch rupture.