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The Journal of Cardiovascular Surgery 2002 October;43(5):697-700

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Traumatic innominate artery transection

Anastasiadis K., Channon K. M., Ratnatunga C.

Oxford Heart Center John Radcliffe Hospital, Headington, Oxford, UK


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Blunt innom­i­nate ­artery inju­ry is a ­rare ­but ­often ­lethal com­pli­ca­tion of ­severe decel­er­a­tion trau­ma. We ­report ­the ­case of a 38-­year-­old ­man ­with ­such an inju­ry ­who ­was suc­cess­ful­ly oper­at­ed on an emer­gen­cy ­basis. In cas­es of brach­i­oc­e­phal­ic ves­sel trau­ma, a ­high ­index of sus­pi­cion in ­chest decel­er­a­tion inju­ries ­may ­lead to a prop­er inves­ti­ga­tive pro­cess ­and an accu­rate diag­no­sis. Clinical ­signs as ­blood pres­sure gra­di­ent ­between ­the ­arms ­and wid­en­ing of ­the med­i­as­ti­num on ­chest X-­ray is high­ly sug­ges­tive of trau­ma of ­the tho­rac­ic aor­ta ­and ­its ­great ves­sels. A ­chest CT ­scan ­may con­trib­ute to ­the diag­no­sis ­and ­can ­rule ­out ­major trau­ma of ­the aor­ta, ­but ­the pro­ce­dure of ­choice ­for ­the def­i­nite diag­no­sis is usu­al­ly ­the angio­gra­phy. Subsequent ear­ly ­repair is favor­able to ­avoid com­pli­ca­tions ­and ­fatal ­events. Cardiopulmonary ­bypass ­use in select­ed cas­es ­favors ­the out­come.

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