| Abstract
| - Direct repair of traumatic aortic isthmic transection eliminates thelate complications of prosthetic graft repair. This study evaluates thelong-term fate of direct aortic repair to which little attention has beenpaid. Among 32 patients operated upon from 1965 to 1987, 27 (84%) underwentdirect repair. The tear was circumferential in 15 patients and partial in12. Multiple traumatic lesions were present in 26 patients, includingintracranial injury in 19. Partial cardiopulmonary bypass was used in 15patients and simple aortic cross-clamping in 12. No paraplegia wasobserved. There were 4 deaths from associated lesions among the 14 patientsoperated upon for acute traumatic isthmic transection and no deaths in theothers. Among the 23 survivors, 4 were lost to follow-up; the other 19patients have excellent clinical results. Intravenous digital aorticangiography performed in 14 patients at a mean delay of 5 years 3 monthsshowed excellent aortic reconstruction in all cases. Technically moredemanding and faster than a graft interposition, direct repair isrecommended as the procedure of choice in the surgical treatment oftraumatic isthmic transection, particularly in young patients, the groupmost at risk from this lesion.
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