Document Detail


Surgical outcome of traumatic aortic disruption of the thoracic aorta in Songklanagarind Hospital.
MedLine Citation:
PMID:  15516005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This retrospective study collected data from 11 patients who underwent TDTA' repair from February 1987 to June 2003, 10 patients were men (90.9%) and 1 was a woman (9.09%) with a mean age of 32 years. All patients had a blunt injury from a violent motor vehicle accident. None of them required thoracotomy at the emergency room. Standard chest x-ray was done in every patient and the widening of the upper mediastinum was mainly found in 10 patients (90.9%), hemothorax in 8 patients, blurred aortic knob in 7 patients, lower left main bronchus in 3 patients, pleural apical cap in 2 patients and pneumothorax in 1 patient, 8 patients were investigated by CT scan and presented a positive study. 3 patients (27.27%) were diagnosed by both aortogram and CT scan anda pseudo-false aneurysm was found Multi organ system injury was mainly found in 10 patients (90.91%). 7 patients (63.64%) had hypovolumic shock on admission, 3 patients died postoperation and 2 of them had experience of postoperative paraplegia. Clamp and sew technique was used in 6 patients (54.54%). The duration of aortic cross clamp time ranged from 19-67 minutes (mean time = 39.30 min.) Pneumonia was the significant postoperative complication found in 3 patients, including acute renal failure, ARDS (all died) and paraplegia in 2 patients. The duration of the aortic cross clamp time that was used in the patients who presented with paraplegia was more than 40 minutes. 1 patient had delayed the aortic repair for 3 weeks resulting from severe brain contusion. 5 patients (45.45%) died in hospital. 1 patient died in the operating theatre, 4 of them (36.36%) died during postoperatively within 24 hours. The mainly cause of death which occurred in every patient was intraoperative cardiac arrest, the others were postoperative bleeding, ARDS and arrhythmias. The mean of length of stay in the intensive care unit was 6.94 days. The period of hospitalization ranged from 11 to 180 days (mean = 62.83 days). The small sample size is the limitation for the present study. The authors plan to do prospective study about the factors which influence the mortality rate and factors related to postoperative paraplegia in TDTA patients at Songklanakarind Hospital.
Authors:
Voravit Chittithavorn; Prasert Vasinanukorn; Chareonkiat Rergkliang; Apirak Chetpaophan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  87     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-11-01     Completed Date:  2004-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  1048-55     Citation Subset:  IM    
Affiliation:
Department of Surgery, Faculty of Medicine, Prince of Songkla University, Thailand.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic
Adult
Aorta, Thoracic / injuries*,  surgery
Aortic Rupture / surgery*
Female
Humans
Male
Paraplegia / etiology
Postoperative Complications
Retrospective Studies
Thailand
Treatment Outcome
Wounds, Nonpenetrating / surgery*

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