Blunt Aortic Injury

Author: Dawn S. Hui, MD
Institution: Saint Louis University
Date Reviewed: November 2013
Learning Domain: Adult Cardiac Surgery
Learning Objective: Evaluation of and surgical management of blunt traumatic aortic injury
PowerPoint File: Blunt Aortic Injury

Discussion Points

• Grading system of blunt aortic injury
• Timing of aortic repair in context of concomitant injuries
• Operative management 
  • TEVAR: Femoral artery access/left subclavian artery management/spinal drain/systemic heparinization
  • Open Repair: Single lung ventilation/full vs partial bypass vs shunt vs clamp and sew/spinal cord protection
• Optimal Follow-up Strategy

Learning Points

• Traumatic aortic rupture patients often have multiple severe injuries
• Decision for timing, TEVAR vs. open repair, and perioperative management is an individualized one
• Lack of long-term data mandates lifelong follow-up for patients managed by TEVAR