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On the Operative Stress of Clamp-and-Sew Technique in Traumatic Aortic Rupture: A Short Commentary

Joon Yong Cho and Shin-Ah Son 

Untreated, approximately 30% of surviving patients admitted to a hospital for traumatic thoracic aortic injury (TTAI) die within the first 24 h [1]. Despite the increased use of restraint systems, the overall incidence of fatal vehicular crash-associated TTAIs and diagnostic rates of aortic injury have begun to increase owing to the commercialization of computed tomography. For such a fatal damage, immediate operative repair used to be the rule. However, the use of cardiopulmonary bypass with a significant amount of heparin immediately after trauma can exacerbate other accompanying injuries. To reduce this risk, here we discuss our experience with performing traumatic aortic repair as early as possible using the clamp-and-sew technique but without administering intravenous heparin and initiating distal aortic perfusion. Between January 2002 and December 2017, a total of 92 patients were diagnosed with TTAI at our regional trauma center. Out of 92 patients, 22 patients underwent clamp-andsew technique for traumatic descending aortic rupture.