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AL Estrera, MD, D Gochnour, MD, CC Miller III, PhD,

Progress in the Treatment of Blunt Thoracic Aortic Injury: 12-year Single Institution Experience. AL Estrera, MD, D Gochnour, MD, CC Miller III, PhD, A Azizzadeh, MD, S Coogan, MD,J Holcomb, MD, H Safi, MD. Department of Cardiothoracic and Vascular Surgery

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AL Estrera, MD, D Gochnour, MD, CC Miller III, PhD,

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  1. Progress in the Treatment of Blunt Thoracic Aortic Injury: 12-year Single Institution Experience AL Estrera, MD, D Gochnour, MD, CC Miller III, PhD, A Azizzadeh, MD, S Coogan, MD,J Holcomb, MD, H Safi, MD Department of Cardiothoracic and Vascular Surgery The University of Texas Medical School at Houston Memorial Hermann Heart & Vascular Institute Aortic Surgery Symposium 2010 New York, NY April, 2010

  2. Purpose • Recent advancements in the diagnosis and management of blunt thoracic aortic injury (BTAI) have improved outcomes following operative repair. • With consideration of these advancements, we analyzed our Level 1 trauma experience with BTAI.

  3. Methods 255 Blunt Thoracic Aortic Injury Jan. 1997 – March 2009 Median age: 39 (13-91) 71% 29%

  4. Management ABC’s Extremis Stable EC Thoracotomy Resuscitate or Evaluate Operating Room Radiographic

  5. Presentation Acute Delayed Selective Management Endovascular Repair Surgery

  6. Delayed Selective Rx • Severe Head Injury • Infection • Burns • Sepsis • Contaminated wound • Multi-system Trauma

  7. Results *(p<0.002)

  8. Operative Mortality TAI

  9. Overall Mortality TAI- All Patients

  10. Although thoracic aortic injury still accounts for significant mortality during blunt trauma, patients reaching specialized trauma centers can achieve good results with thoracic aortic repair. Improved early outcomes have been observed with delayed selective management and thoracic endovascular repair. Long-term results of TEVAR, however, need further study. Conclusions

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