Ascending aortic injury repair

Thoracic aortic injury is usually seen in closed injury, and most of the wartime is penetrating injury. The incidence rate is 6% to 10%. The incidence of thoracic aortic rupture in American traffic accidents accounts for about 15% of chest injuries. More than 80% of closed injuries occur in the aortic isthmus, and about 5% to 20% are located at the beginning of the ascending aorta. These two parts are relatively fixed, so they are easily broken after being subjected to violence or sudden deceleration. In a few cases, More than one laceration occurred. The degree of tear is different, mostly transverse rupture, can be full-layer rupture, can also be the endometrial, middle rupture and the outer layer and pleura temporarily maintain blood flow, followed by tumor-like dilatation or pulsatile hematoma, so-called Traumatic pseudo-aortic aneurysm. When the thoracic aorta ruptures, only 10% to 20% of the patients can be sent to the hospital, and more than 80% of the patients die from major bleeding on the spot or in transit. If the ascending aorta ruptures in the pericardium, causing acute cardiac tamponade, it is difficult to distinguish it from a heart injury. Treatment of disease: ascending aortic aneurysm 1. The chest is in the middle of the incision, slowly pulling the sternum and cutting the happy bag. Surgery should be performed at the distal end of the ascending aorta and cardiac arrest. The damage is mostly located in the pericardium, so it is necessary to control the preparation of aortic bleeding before cutting the happy bag. 2, after cutting the happy bag, the hemorrhage of the ascending aorta can be used to stop bleeding with a finger. 3, the rupture of the simple front wall can often be directly sutured with 4-0 polyester thread. 4, the mouth is in the back wall, you can also use the finger to stop the hemostasis, in the cardiopulmonary bypass, the heart is revealed to break, repair. 5. The method of repair should be determined according to the severity and extent of the wound.

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