Repair of Traumatic Thoracic Aortic Injury Without Shunt, and Using a Woven Dacron Graft


Fig. 4.1

Dissect out left subclavian artery and control it with umbilical tape




../images/467973_1_En_4_Chapter/467973_1_En_4_Fig2_HTML.png

Fig. 4.2

Dissect and retract the left vagus nerve with a vessel loop while identifying and avoiding the phrenic nerve



../images/467973_1_En_4_Chapter/467973_1_En_4_Fig3_HTML.png

Fig. 4.3

Being careful not to enter the hematoma, dissect the space between the left subclavian and common carotid arteries, and then circumferentially around the proximal aorta at this level. Blunt finger dissection is often required. Avoid injury to the pulmonary artery, which lies just inferior to the aortic arch. Place an umbilical tape around the aorta for proximal control



../images/467973_1_En_4_Chapter/467973_1_En_4_Fig4_HTML.png

Fig. 4.4

Circumferentially dissect and control the descending aorta with umbilical tape, distal to the hematoma. Loop the intervening intercostal arteries with 2-0 silk ligatures



../images/467973_1_En_4_Chapter/467973_1_En_4_Fig5_HTML.png

Fig. 4.5

Cross clamp the proximal aorta, left subclavian artery, and descending aorta at the sites dissected. Have anesthesiologist keep track of cross-clamp time


Oct 20, 2020 | Posted by in GENERAL SURGERY | Comments Off on Repair of Traumatic Thoracic Aortic Injury Without Shunt, and Using a Woven Dacron Graft

Full access? Get Clinical Tree

Get Clinical Tree app for offline access