BACKGROUND: @entity397 of the thoracic aorta is a relatively common injury of deceleration accidents, usually high-speed motor vehicle accidents. @entity1566 has been a well-documented complication of surgical management. The use of nonheparinized partial bypass with a centrifugal pump was evaluated for protection against @entity1566 and reduction of risk of associated injuries. METHODS: From 1989 to 1999, the third decade of the authors' experience, @entity397 was diagnosed in 58 @entity1 (male 46 and female 12; mean age 39.9 years, range 17 to 85). Associated injuries were documented in 98.3% (57 @entity1 ). In all, 45 @entity1 (77.6%) had the opportunity for definitive surgical management; 42 (93.3%) were managed with partial cardiopulmonary bypass, 35 without the use of heparin. Full cardiopulmonary bypass was utilized in 1 @entity1 while 2 had repair without cardiopulmonary bypass support. Thirteen @entity1 did not have the opportunity for definitive surgical management, 1 @entity204 on arrival, 8 (61.5%) suspected, and 4 (30.8%) diagnosed. RESULTS: There were 6 deaths in the surgical group, 5 in nonheparinized @entity1 . The causes were @entity3485 (2), anoxic @entity1620 after intraoperative @entity1167 (1), @entity295 (1), and adult @entity649 (1). The other was in the simple aortic cross-clamp group from intraoperative pulmonary compromise. There was one @entity1566 , paraparesis in 1 of the 2 @entity1 managed without bypass support. The total hospital stay ranged from 8 to 112 days, primarily owing to management of associated injuries. Of the 13 @entity1 who did not have the opportunity for definitive surgical management, 5 had unsuccessful emergency thoracotomy and 3 survived the hospital course without surgery. Of the total population, the overall mortality was 27.6%, whereas the mortality of the potentially operable @entity1 was 25.8%. Of the surgical group, the intraoperative mortality was 6.7% and 30-day mortality was 13.3%. CONCLUSIONS: @entity1566 was prevented by the use of partial cardiopulmonary bypass. Nonheparinized bypass was likely to be a contributory factor to lack of mortality directly related to associated injuries.

XXXX of the thoracic aorta: third decade of experience.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity649 :: ('MESH:D012128', 'Disease') :: ['respiratory distress syndrome'] @entity1620 :: ('MESH:D001926', 'Disease') :: ['brain death'] @entity397 :: ('MESH:D012421', 'Disease') :: ['Traumatic rupture', 'traumatic rupture'] @entity3485 :: ('MESH:D020896', 'Disease') :: ['intraoperative hypovolemia'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity1566 :: ('MESH:D013119', 'Disease') :: ['Spinal cord injury', 'spinal cord injury'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity397 :: (MESH:D012421,Disease) :: ['Traumatic rupture']
