CHRONIC TRAUMATIC THORACIC ANEURYSM - INFLUENCE OF OPERATIVE TREATMENT ON NATURAL-HISTORY - AN ANALYSIS OF REPORTED CASES, 1950-1980

  • 1 January 1982
    • journal article
    • review article
    • Vol. 84  (2) , 257-266
Abstract
A total of 401 cases of chronic traumatic aneurysm reported during the past 30 yr plus 12 cases from the University of Virginia Medical Center [Virginia, USA] were analyzed. Of the patients, 42% developed signs or symptoms of aneurysm expansion within 5 yr of injury, 85% within 20 yr. Pain was the most frequently occurring sign or symptom, followed by serial enlargement on chest roentgenogram. Of the 60 patients who were followed without operative intervention, 20 died of their aortic lesions. For these patients, the combined risk of dying or developing signs or symptoms was 41% at 5 yr. Over 300 patients underwent operative repair of the aneurysm. Operative mortality was 4.6%. Bleeding was the major cause of death as well as the most common major complication. When the survival probability of patients treated operatively was compared with that of patients treated nonoperatively, the operative group demonstrated a significantly higher survival probability.