There has appeared in the literature only one report of the successful suture of a wound of the thoracic aorta. This operation was performed by Dshanelidze1 of Russia. The reasons for the scarcity of successful cases are several. For purposes of this discussion, the aorta is divided into two portions; namely, that part which is within the pericardium and that which is without. Piercing injuries of the extrapericardial portion of the thoracic aorta usually result in early death because there is no surrounding structure such as the pericardium to limit the loss of blood. The infrequency of wounds of the intrapericardial part of the aorta is due to its position behind the sternum and to the fact that it is quite short.
I have noted in studies on animals that relatively small wounds of the intrapericardial portion of the aorta are usually fatal unless treatment is instituted. A wound
Blalock A. SUCCESSFUL SUTURE OF A WOUND OF THE ASCENDING AORTA. JAMA. 1934;103(21):1617–1618. doi:10.1001/jama.1934.72750470001008