Traumatic Aortic Aneurysm: Excision and Anastomosis without a Graft

Traumatic aneurysms of the thoracic aorta differ from arteriosclerotic, luetic, and other aneurysms due to diffuse vascular disease, in important respects. Typically, the patient is young, healthy, and the aneurysm arises from a linear, transverse disruption of the intima and media with no significant loss of adjacent, normal vessel. These distinctive pathologic features form the basis for the therapeutic concept that traumatic aneurysm should usually be susceptible to excision with direct, graftless restoration of aortic continuity. The validity of this concept is apparent on pathologic grounds; its practical application has now been established by clinical usage. Based on experience with two cases so treated with the aid of left-atrial femoral artery bypass, the authors outline the steps of the operative procedure.