Methods: Retrospective chart and database review was performed for patients with repair of blunt traumatic thoracic aortic tears from 1/03 to 9/06.

Results: In the 44 month study period there were 30 aortic repairs for blunt traumatic tears: 20 open and 10 endografts. 10 of the last 11 repairs were endografts. Immediate technical success was achieved in 9/10 endograft cases with complete exclusion of the tear and one temporary type 1 endoleak. Stent revisions were performed in two patients due to infolding of the proximal stent segment on the lesser curve. There was one retrograde dissection caused by stenting necessitating replacement of the ascending aorta. There were no deaths, CVAs or paraplegia in the endovascular group at most recent follow-up. Open repairs were via left thoracotomy with partial femoral-femoral bypass (17/20) full bypass (3/20) and 2 with circulatory arrest. There were 3 deaths, no CVAs, no paraplegia and 2 vocal cord paralyses in the open group.

Conclusion: Our data demonstrate a high degree of early technical success with endografting traumatic aortic tears with low morbidity and no mortality. We support evaluating each patient individually with a preference for stenting if feasible. We utilize a multidisciplinary approach with cardiothoracic surgery as the team leader and vascular surgery, cardiology and interventional radiology in support.