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MANAGEMENT OF TRAUMATIC RUPTURE OF THE AORTIC ISTHMUS

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Author(s): C. Moroşanu | C. Roată | S. Luncă

Journal: Jurnalul de Chirurgie
ISSN 1584-9341

Volume: 5;
Issue: 1;
Start page: 26;
Date: 2009;
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Keywords: AORTIC ISTHMIC RUPTURE | TRAUMA | SURGERY

ABSTRACT
Traumatic rupture of the aortic isthmus is a rare lesions occurring usually in patients subjected to sudden deceleration in cars accidents. This lesion is a potentially fatal injury that leads to death in 75-90% of cases at the time of injury. However, patients who survive to reach the hospital have the chance to overpass this dramatic situation. Computer tomography and transesophageal echocardiography are of great value in making the diagnosis. Open surgery with conventional repair is still considered the gold standard technique for cases of isolated rupture. Delayed management approach with controlled hypotension and radiological monitoring is a safe and recommended option for patients with severe multiple injuries or co-morbidities that put surgery at high risk. Urgent endovascular stenting offers a minimally invasive method that has been shown to be a feasible, safe and efficient technique which may be proposed as a therapeutic alternative for patients with multiple trauma instead of delayed surgical repair after stabilization. In Romania few patients with traumatic aortic rupture arrive alive at the hospital. However, with the progresses in the first aid and transportation of the trauma patients, in our hospitals such cases will appear more frequently and surgeons working in emergency hospitals should be prepared to manage such dramatic cases.
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