Difficulties with endograft sizing in a patient with traumatic rupture of the thoracic aorta: The possible influence of hypovolemic shock

A patient with traumatic thoracic injury and hypovolemic shock is presented to stress important differences in preoperative and postoperative aortic diameters. The patient had a blood pressure of 80/40 mm Hg. A diagnostic computed tomography angiography revealed a rupture of the thoracic aorta, and...

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Bibliographic Details
Published in:Journal of vascular surgery 2008-06, Vol.47 (6), p.1333-1336
Main Authors: van Prehn, Joffrey, MD, van Herwaarden, Joost A., MD, PhD, Muhs, Bart E., MD, PhD, Arnofsky, Adam, MD, Moll, Frans L., MD, PhD, Verhagen, Hence J.M., MD, PhD
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Aorta, Thoracic - diagnostic imaging
Aorta, Thoracic - injuries
Aorta, Thoracic - physiopathology
Aorta, Thoracic - surgery
Aortic Rupture - complications
Aortic Rupture - diagnostic imaging
Aortic Rupture - physiopathology
Aortic Rupture - surgery
Aortography
Biological and medical sciences
Blood and lymphatic vessels
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Cardiology. Vascular system
Diseases of the aorta
Hemodynamics
Humans
Male
Medical sciences
Motorcycles
Prosthesis Design
Shock - diagnostic imaging
Shock - etiology
Shock - physiopathology
Shock - surgery
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tomography, X-Ray Computed
Treatment Outcome
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Description
Summary:A patient with traumatic thoracic injury and hypovolemic shock is presented to stress important differences in preoperative and postoperative aortic diameters. The patient had a blood pressure of 80/40 mm Hg. A diagnostic computed tomography angiography revealed a rupture of the thoracic aorta, and a thoracic endograft was sized based on these data. However, the postoperative computed tomography angiography (Riva-Rocci, 164/70 mm Hg) showed an increase in aortic diameters of about 30% at multiple levels. In this patient, with rupture of the thoracic aorta and hypovolemia, the aortic diameter was significantly decreased. This indicates that adequate preoperative sizing for endovascular repair of vascular pathology in patients in shock is complicated.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2007.12.036