TY - CHAP M1 - Book, Section TI - Chapter 56. Trauma to the Great Vessels A1 - Ruddy, Jean Marie A1 - Ikonomidis, John S. A2 - Cohn, Lawrence H. PY - 2012 T2 - Cardiac Surgery in the Adult, 4e AB - Injury to the aorta and great vessels of the thorax may occur secondary to blunt or penetrating trauma, and appropriate management of immediate hemorrhage as well as that resulting from subsequent pseudoaneurysm rupture should be the primary goal of the treating surgeon.1 Blunt aortic injury is the most common thoracic vascular injury following blunt trauma and the second leading cause of death from motor vehicle collision, accounting for 15% of deaths.2–4 In 75 to 90% of cases, death occurs at the accident scene, typically in those with four or more serious injuries in addition to their aortic transection.2–5 After aortic transection at the isthmus, aortic disruption at the base of the innominate artery is the most common site of injury, followed by the base of the left subclavian artery, and the base of the left carotid.6 Central venous structures are rarely injured with blunt trauma,7 but this can occur with penetrating trauma.8 Traditionally, open surgical repair of these injuries has proved effective, but recent literature has demonstrated the safety and efficacy of endovascular interventions.9 This chapter examines trauma to each of the thoracic vessels and presents diagnostic modalities as well as treatment options. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/04/18 UR - accesssurgery.mhmedical.com/content.aspx?aid=55927201 ER -