Korean J Thorac Cardiovasc Surg.  2017 Aug;50(4):295-297. 10.5090/kjtcs.2017.50.4.295.

Unusual Presentation of a Penetrating Aortic Arch Injury

• Vural FS
• Patel AK
• Mustafa K

• KMID: 2387918
• DOI: http://doi.org/10.5090/kjtcs.2017.50.4.295

Abstract

A 27-year-old man was admitted with a penetrating injury at the mid-manubrium. Computed tomographic (CT) angiography showed a filling defect in the aortic arch. This was evaluated as a sign of injury and the patient underwent an emergency operation. No active bleeding or clot was found in the mediastinum during the operation. The laceration point was between the innominate and the left carotid artery posteriorly. The injury was approached using hypothermic circulatory arrest. Aortotomy and exploration showed a 2-cm-long full-thickness aortic injury with an overlying clot. A filling defect on angiography as a sign of a penetrating arch injury has never been reported previously, but was the main pathological finding on CT angiography in our case. The aorta is a high-pressure system and injuries to it should be treated aggressively.

Keyword

Aorta, thoracic; Hypothermia; Circulatory arrest deep hypotermia induced; Penetrating trauma

MeSH Terms

Adult
Angiography
Aorta
Aorta, Thoracic*
Carotid Arteries
Emergencies
Hemorrhage
Humans
Hypothermia
Lacerations
Mediastinum