In the five-year period ending in October, 1975, 31 consecutive @entity1 with @entity397 of the thoracic aorta underwent surgery at the University of Maryland Hospital or the Maryland Institute for Emergency Medicine. All cases were confirmed by preoperative aortogram. Rupture was confined to one or more sites in the descending thoracic aorta at or distal to the origin of the left subclavian artery. The age was a mean of 26 years. Operation was done within an average of 18 hours after injury. Significant @entity130 were present in every case. Six @entity1 with positive findings on peritoneal lavage underwent exploratory laparotomy prior to thoracotomy because of shock. Surgical repair was done by use of left heart bypass in 2 cases (one death), a passive aorta-aorta shunt in 23 cases (5 deaths), and without shunt or bypass in 6 cases (no deaths). An end-to-end tubular Dacron graft was used to reconstruct the aorta in all but one @entity1 . Over-all survival rate was 25 of 31 @entity1 (81 per cent). @entity451 developed in one @entity1 and @entity177 in 3 @entity1 (2 deaths) in the aorta-aorta shunt group. @entity101 was present in 18 (72 per cent) of the survivors. Palsy of the left recurrent laryngeal nerve persisted in 8 (32 per cent) of the survivors. Two of the deaths were related to technical problems of the shunting procedure and 2 to intrapleural exsanguination before proximal aortic control could be achieved. Complications and @entity190 were reduced in the group with no shunt. The series lends support to the rigorous aortographic search for ruptured thoracic aortas in @entity130 @entity1 with widened @entity6830 . Once experience has been gained with shunting techniques, tears of the descending thoracic aorta may be safely repaired without shunt if done expeditiously.

XXXX of the aorta. A five-year experience.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity101 :: ('MESH:D006973', 'Disease') :: ['Hypertension'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity397 :: ('MESH:D012421', 'Disease') :: ['traumatic rupture'] @entity451 :: ('MESH:C536857', 'Disease') :: ['Paraplegia'] @entity6830 :: ('MESH:D008479', 'Disease') :: ['mediastinum'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma', 'nonthoracic injuries']
@entity397 :: (MESH:D012421,Disease) :: ['Traumatic rupture']
