LEFT SUBCLAVIAN ARTERY RUPTURE DUE TO BLUNT THORACIC TRAUMA: A CASE REPORT
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Abstract. Blunt thoracic trauma highest incidence is in adult, 20% to 50 % of the trauma cause death. Injuries to the vascular structures of the thoracic outlet, especially left subclavian artery, are rare and typically accompanied by massive hemorrhage. Close observation of vital sign and serial chest x-ray are very important. We describe an unusual presentation of a patient who suffered traumatic rupture ofleft subclavian artery. No clinical presentation of supraclavicular hematoma, unilateral absence of radial artery pulse and mediastinal widening in chest x-ray was found, but there is a massive hemothorax. Left posterolateral thoracotomy was performed, the source of bleeding was found in the apex of the lung, suspected a rupture of the left subclavian artery. The procedure continued with median sternotomy extended to left supraclavicular incision, a rupture was found in the left subclavian artery, 1,5 cm proximal to aortic arch. Primary repair was done with a good result. Key Words : Blunt thoracic trauma, massive hemothorax, left subclavian artery ruptureKeywords:
Hemothorax
Thoracotomy
Blunt trauma
Great vessels
Median sternotomy
Left subclavian artery
Methods We performed 11 carotico-subclavian bypass operations between August 2009-January 2013 at our department. 8 patients were operated for subclavian steal syndrome with subclavian artery occlusion and 3 patients were operated before TEVAR for aortic dissection/aneursym necessiating left subclavian artery coverage. 9 male (81.81%) and 2 female (18.18%) patient with the age between 55-73 (mean 64.9) were operated. 8mm Dacron graft was used for nine patients and 7/8mm PTFE for two patients. Anastomosis were done in end-to-side fashion.
Cardiothoracic surgery
Center (category theory)
Vascular surgery
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Abstract. Blunt thoracic trauma highest incidence is in adult, 20% to 50 % of the trauma cause death. Injuries to the vascular structures of the thoracic outlet, especially left subclavian artery, are rare and typically accompanied by massive hemorrhage. Close observation of vital sign and serial chest x-ray are very important. We describe an unusual presentation of a patient who suffered traumatic rupture ofleft subclavian artery. No clinical presentation of supraclavicular hematoma, unilateral absence of radial artery pulse and mediastinal widening in chest x-ray was found, but there is a massive hemothorax. Left posterolateral thoracotomy was performed, the source of bleeding was found in the apex of the lung, suspected a rupture of the left subclavian artery. The procedure continued with median sternotomy extended to left supraclavicular incision, a rupture was found in the left subclavian artery, 1,5 cm proximal to aortic arch. Primary repair was done with a good result. Key Words : Blunt thoracic trauma, massive hemothorax, left subclavian artery rupture
Hemothorax
Thoracotomy
Blunt trauma
Great vessels
Median sternotomy
Left subclavian artery
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Aneurysms of the intrathoracic subclavian artery are extremely rare. A 74 year-old man was referred to our hospital with an abnormal chest X-ray film. Contrast computed tomography revealed an intrathoracic left subclavian artery aneurysm. Via left 4th posterolateral thoracotomy, the aneurysm was exposed under systemic deep hypothermia and circulatory arrest. The distal arch was replaced with a 26 mm single-branched graft and the left subclavian artery was reconstructed with a 10 mm graft.
Left subclavian artery
Thoracotomy
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Two infants with coarctation of the aorta were successfully repaired by the modified method of subclavian flap aortoplasty with preservation of arterial blood flow to the left arm. The left subclavian artery was detached from the aorta at its origin, opened longitudinally in its posterior wall and sutured over the coarctation site. Widening of the stenosis and preserving of the blood flow to the left arm were obtained. This operative technique seems advantageous without complications induced by sacrificing the continuity of the subclavian artery, reserving the advantages of the former subclavian flap aortoplasty.
Left subclavian artery
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Left subclavian artery
Mammary artery
Cardiac catheterization
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Two patients with neurofibromatosis presented with expanding masses at the left supraclavicular region. Computed tomography (CT) scans revealed vascular masses. The patients underwent surgery and ruptures of the left subclavian artery were found. Both patients were treated by ligation of subclavian artery.
Left subclavian artery
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Hemothorax
Left subclavian artery
Left lung
Bronchial artery
Parenchyma
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Spontaneous rupture of the branches of left subclavian artery (LSA) without any obvious risk factors is rare.A 51-year-old female patient without history of trauma and hypertension complained about left chest pain.A chest Computed tomography (CT) scan revealed a large pleural effusion (PE) in the left thorax cavity and hemothorax was confirmed by thoracentesis.The patient underwent surgery.spontaneous rupture of the branches of LSAwas confirmed.The patient recovered well and discharged after timely treatments. The unusual possibility should be paid attention in mind in acute chest pain cases.
Hemothorax
Thoracentesis
Left subclavian artery
Thorax (insect anatomy)
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Ligature
Left subclavian artery
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Hemothorax
Left subclavian artery
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