Acute and Chronic Traumatic Aneurysms of the Descending Thoracic Aorta

Abstract

A 10-year experience in the surgical treatment of traumatic aneurysms of the descending thoracic aorta is reviewed. This series included 40 patients equally divided into two groups. Group I comprised 20 acute ruptures and group II, 20 chronic traumatic aneurysms, all situated at the aortic isthmus. The surgical repair was performed in all patients with a single method of aortic shunting. A Gott aneurysm shunt was used as a temporary external bypass between the ascending and the descending aorta, giving priority to organ protection during aortic cross-clamping. The survival rate was 95% (38/40). The two deaths occurred in the acute group and were related to severe brain trauma present before surgery. The aortic cross-clamping time averaged 43 minutes. Regarding organ protection, no brain damage, no heart failure, no renal dysfunction, and no paraplegia occurred. These results emphasize the safety and the reliability of this shunting procedure.