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Case Reports
. 2020 May 11:27:100307.
doi: 10.1016/j.tcr.2020.100307. eCollection 2020 Jun.

Transection of the origin of the innominate artery: A rare sequela of blunt traumatic chest trauma

T Lovelock  1 , A Cheng  1 , J Negri  1 , M Fitzgerald  2
Affiliations
Case Reports

Transection of the origin of the innominate artery: A rare sequela of blunt traumatic chest trauma

T Lovelock et al. Trauma Case Rep. .

Erratum in

Abstract

Blunt traumatic transection of the innominate artery is rare. We describe a case of a 36-year-old male who presented to our Emergency & Trauma Center after being struck by a motor vehicle at high speed. Computerised Tomography (CT) scanning after the patient was stabilised facilitated the prompt diagnosis of the injury. The patient underwent open repair by midline sternotomy, with debranching of the innominate artery, using hypothermic circulatory arrest as a neuroprotective measure. The patient was successfully extubated on post-operative day 3, without neurological deficit. We provide our experience as an option for treating any patient that presents with such an injury.

Keywords: Blunt trauma; Innominate artery; Thoracic trauma; Vascular trauma.

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Figures

Fig. 1
Fig. 1
Chest X-ray on admission. The patient's admission chest X-ray demonstrated a right sided haemopneumothorax with associated deep sulcus sign. There is a widened superior mediastinum.
Fig. 2
Fig. 2
Axial (panel A) and Coronal (panel B) slices of the patient's admission Computerised Tomography (CT) scan, which demonstrated a brachiocephalic trunk transection just distal to its origin, with an adjacent 23 × 28 × 38mm pseudoaneurysm (indicated by black arrow).
Fig. 3
Fig. 3
A sagittal slice of a CT scan done post-operatively demonstrates the debranched brachiocephalic trunk (indicated by black arrow), which was reimplanted to the right side of the ascending aorta via a 10 mm vascular graft.
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