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ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 2  |  Page : 101-105

Observational management of Grade II or higher blunt traumatic thoracic aortic injury: 15 years of experience at a single suburban institution


1 Department of Trauma Surgery Trauma Center, Chungbuk National University Hospital, Cheongju, Korea
2 Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
3 Department of Radiology, Chungbuk National University Hospital, Cheongju, Korea
4 Department of Cardiovascular and Thoracic Surgery, Trauma Center, Chungbuk National University Hospital, Cheongju, Korea
5 Department of Trauma Surgery Trauma Center, Chungbuk National University Hospital; Department of Trauma Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
6 Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, Korea

Correspondence Address:
Dr. Jin Young Lee
Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital Cheongju 28644
Korea
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijciis.ijciis_89_21

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Background: We aimed to investigate the outcomes after delayed management of ≥ Grade II blunt traumatic thoracic aortic injury (BTAI). Methods: Between January 2005 and December 2019, we retrospectively reviewed the medical records of 21 patients with ≥ Grade II thoracic aortic injury resulting from blunt trauma. Twelve patients underwent observation for the injury, whereas nine patients were transferred immediately after the diagnosis. Patients were divided into a nonoperative management group (n = 7) and delayed repair group (n = 5) based on whether they underwent thoracic endovascular aneurysm repair or surgery. Results: The most common dissection type was DeBakey classification IIIa (n = 9). Five patients underwent delayed surgery (including aneurysm repair), with observation periods ranging from 1 day to 36 months. The delayed repair group exhibited higher injury severity scores than the nonoperative management group (n = 7). The nonoperative management group was followed-up with blood pressure management without a change in status for a period ranging from 3 to 96 months. Conclusions: Our findings indicated that conservative management may be appropriate for select patients with Grade II/III BTAI, especially those exhibiting hemodynamic stability with anti-impulse therapy and minimally sized pseudoaneurysms. However, further studies are required to identify the risk factors for injury progression and long-term outcomes.


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