A national review of surgically treated blunt traumatic thoracic aortic transections

Abstract

Blunt traumatic transection of the aorta (BTTA) is associated with a very high mortality rate. Most victims die at the time of the injury. A review of surgically treated BTTA in Ireland between 1989 and 2002 was performed. The accident files of all road traffic deaths during 2001 and incidence data on national road traffic deaths for the study period were also reviewed. There were 30 acute and 9 chronic BTTA. Of the 30 acute transections, 29 were due to road traffic accidents (RTA) and one a crush injury. Major associated injuries included head injuries (7), fractures (13) with paraplegia in 2 and abdominal injuries requiring surgery in 4. There were 3 (10%) hospital deaths (2 arrested on induction) and no cases of postoperative paraplegia. In 2001, 18.4% of RTA victims had a BTTA on post-mortem and 8.7% of these survived to hospitalisation. 60% of BTTA victims surviving to hospitalisation have undergone successful repair. BTTA must be considered following blunt trauma and should be out-ruled by present scanning techniques. © 2005 Springer.