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November 1964

Rupture of Thoracic Aorta Due to Closed-Chest Trauma

Arch Surg. 1964;89(5):840-847. doi:10.1001/archsurg.1964.01320050086007

Traumatic rupture of the thoracic aorta is not necessarily a fatal injury. Although over 80% of victims1 so injured die before reaching a hospital, the immediate survivors should all be candidates for successful emergency surgical correction if the diagnosis is made promptly. Reported experience suggests, however, that surgical intervention has rarely been attempted despite the evidence that 80% of these immediate survivors will die of secondary hemorrhage within three weeks of their injury. Those few patients who survive both the initial injury and the period when secondary hemorrhage occurs may live for long periods without treatment. However, most of them develop a post-traumatic aneurysm which eventually requires surgical treatment.2

A review of the literature3-8 reveals that early operation for aortic rupture has only very rarely been successful (Table). It is notable that three patients survived early repair (39 hours or less after injury). Of the four patients

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