Traumatic aortic injury

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Abstract
Traumatic aortic injury is a frequent cause of death in traffic accidents. Surviving patients need prompt diagnosis and treatment. This injury must be systematically considered in cases involving high-speed accidents and suspicion of hemomediastinum on chest radiography. Unstable patients with multisytem trauma may benefit from transesophageal echocardiography in the intensive care unit or operating room without interruption of treatment. For stable patients, angiography can be performed. Ultrafast scanning is a promising method and can be an alternative to other procedures. Delayed surgery can be proposed for stable patients with other life-threatening injuries such as traumatic brain injury or severe hypoxemia. In such cases the use of β blockers may limit the risk of secondary free rupture. The risk of postoperative paraplegia is dramatically increased when the clamping time exceeds 30 minutes, and it is recommended that partial cardiopulmonary bypass be used during surgical repair.

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