Traumatic rupture of the thoracic aorta.

Between 1968 and 1981, 25 patients with acute traumatic rupture of the aorta were treated at the University of Virginia. Twenty-two of these patients (88%) had serious concomitant injuries. The aortic tear was just distal to the left subclavian artery in 19 patients (76%), and at other sites in six patients (24%). Lacerations were at multiple sites in three patients (12%), in the ascending aorta in one (4%), in the distal aortic arch in two (8%), and in the descending aorta well beyond the subclavian artery in six (24%). Two of the patients (8%) died of free rupture of the aorta before reaching the operating room. The other 23 patients (92%) had operation and 17 (68%) survived. At least ten of the 17 survivors (59%), with an average follow-up of seven years, do not have a disability as a result of the injury. In this group, 24 of the 25 traumatic aortic injuries (96%) occurred in the distal aortic arch or the descending aorta and could be repaired through a left posterolateral thoracotomy.