Blunt traumatic aortic injuries of the ascending aorta and aortic arch: a clinical multicentre study.
OBJECTIVE
To report the clinical and radiological characteristics, management and outcomes of traumatic ascending aorta and aortic arch injuries.


METHODS
Historic cohort multicentre study including 17 major trauma patients with traumatic aortic injury from January 2000 to January 2011.


RESULTS
The most common mechanism of blunt trauma was motor-vehicle crash (47%) followed by motorcycle crash (41%). Patients sustaining traumatic ascending aorta or aortic arch injuries presented a high proportion of myocardial contusion (41%); moderate or greater aortic valve regurgitation (12%); haemopericardium (35%); severe head injuries (65%) and spinal cord injury (23%). The 58.8% of the patients presented a high degree aortic injury (types III and IV). Expected in-hospital mortality was over 50% as defined by mean TRISS 59.7 (SD 38.6) and mean ISS 48.2 (SD 21.6) on admission. Observed in-hospital mortality was 53%. The cause of death was directly related to the ATAI in 45% of cases, head and abdominal injuries being the cause of death in the remaining 55% cases. Long-term survival was 46% at 1 year, 39% at 5 years, and 19% at 10 years.


CONCLUSIONS
Traumatic aortic injuries of the ascending aorta/arch should be considered in any major thoracic trauma patient presenting cardiac tamponade, aortic valve regurgitation and/or myocardial contusion. These aortic injuries are also associated with a high incidence of neurological injuries, which can be just as lethal as the aortic injury, so treatment priorities should be modulated on an individual basis.
['Mosquera|Victor X|VX|', 'Marini|Milagros|M|', 'Muñiz|Javier|J|', 'Gulias|Daniel|D|', 'Asorey-Veiga|Vanesa|V|', 'Adrio-Nazar|Belen|B|', 'Herrera|José M|JM|', 'Pradas-Montilla|Gonzalo|G|', 'Cuenca|José J|JJ|']
D000063:Accidents, Traffic D000328:Adult D000368:Aged D001011:Aorta D001013:Aorta, Thoracic D005260:Female D017052:Hospital Mortality D006801:Humans D008297:Male D008875:Middle Aged D008991:Monitoring, Physiologic D018986:Motor Vehicles D009049:Motorcycles D009104:Multiple Trauma D011379:Prognosis D014949:Wounds, Nonpenetrating D014950:Wounds, Penetrating
Aorta Aortic arch Emergency Trauma surgery