Background: There is a paucity of information regarding the management of blunt thoracic aortic injury in the pediatric population compared to adults. This article adds three cases of blunt thoracic aortic injuries in...Background: There is a paucity of information regarding the management of blunt thoracic aortic injury in the pediatric population compared to adults. This article adds three cases of blunt thoracic aortic injuries in pediatric patients to the literature and analyzes these in conjunction with several of the previous case series which have been published. Methods: Three cases were reviewed along with 38 previously reported cases in an attempt to identify trends in demographics and management. The three new cases presented over a four year period. All are male. A six year old and a 17-year-old were involved in motor vehicle crashes and a 10-year-old was struck by a vehicle while skateboarding. Results: The 6-year-old and the 17-year-old were treated non-interventionally due to severe closed head injuries. One received beta blockade. Both survived. The third, without head injury, underwent interposition graft and also survived. Conclusions: These findings are not greatly dissimilar from the adult experience. In reviewing all 41 pediatric cases, findings reveal a high mortality, predominantly due to head injury as well as the aortic injury. Open repair and interposition grafting continue to be the mainstay of management, with endovascular procedures and non-operative management becoming more prevalent recently. The role of beta-blockade is unclear in children with this injury. Further multicenter prospective studies of this rare pediatric injury may be useful.展开更多
本文聚焦于创伤性B型主动脉夹层(traumatic type B aortic dissection, TTBAD)的临床研究进展,总结其发病机制、临床特点与诊断、严重程度划分、治疗方法与预后随访。TTBAD常见于创伤多发伤患者,早期准确诊断至关重要,损伤严重程度是决...本文聚焦于创伤性B型主动脉夹层(traumatic type B aortic dissection, TTBAD)的临床研究进展,总结其发病机制、临床特点与诊断、严重程度划分、治疗方法与预后随访。TTBAD常见于创伤多发伤患者,早期准确诊断至关重要,损伤严重程度是决定TTBAD患者治疗策略与预后的关键,治疗上强调多学科协作,药物治疗和胸主动脉腔内修复术成为主要的治疗选择。但在不同严重程度TTBAD患者的治疗策略与手术时机选择上仍存在一定争议。展开更多
文摘Background: There is a paucity of information regarding the management of blunt thoracic aortic injury in the pediatric population compared to adults. This article adds three cases of blunt thoracic aortic injuries in pediatric patients to the literature and analyzes these in conjunction with several of the previous case series which have been published. Methods: Three cases were reviewed along with 38 previously reported cases in an attempt to identify trends in demographics and management. The three new cases presented over a four year period. All are male. A six year old and a 17-year-old were involved in motor vehicle crashes and a 10-year-old was struck by a vehicle while skateboarding. Results: The 6-year-old and the 17-year-old were treated non-interventionally due to severe closed head injuries. One received beta blockade. Both survived. The third, without head injury, underwent interposition graft and also survived. Conclusions: These findings are not greatly dissimilar from the adult experience. In reviewing all 41 pediatric cases, findings reveal a high mortality, predominantly due to head injury as well as the aortic injury. Open repair and interposition grafting continue to be the mainstay of management, with endovascular procedures and non-operative management becoming more prevalent recently. The role of beta-blockade is unclear in children with this injury. Further multicenter prospective studies of this rare pediatric injury may be useful.
文摘本文聚焦于创伤性B型主动脉夹层(traumatic type B aortic dissection, TTBAD)的临床研究进展,总结其发病机制、临床特点与诊断、严重程度划分、治疗方法与预后随访。TTBAD常见于创伤多发伤患者,早期准确诊断至关重要,损伤严重程度是决定TTBAD患者治疗策略与预后的关键,治疗上强调多学科协作,药物治疗和胸主动脉腔内修复术成为主要的治疗选择。但在不同严重程度TTBAD患者的治疗策略与手术时机选择上仍存在一定争议。
