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Transection of left common carotid artery with arch extension after blunt chest trauma

Department of Thoracic and Cardio-Vascular Surgery, Robert Debré Hospital, Reims, France

^* Corresponding author. Address: Service de Chirurgie Thoracique et Cardiovasculaire, Centre Hospitalier Régional et Universitaire, avenue du Général Koenig, 51092, Reims Cedex, France. Tel.: +33-3 2678-7105; fax: +33-3 2678-3273. (E-mail: sru{at}club-internet.fr).

We report the case of a 63-year-old man, admitted after a traffic accident. Clinical examination found chest trauma, mandibular and long bone fractures but there was no cerebral ischemic signs. The chest X-ray showed a widening of the mediastinum; therefore an aortography demonstrated a false aneurysm, an intimal flap of the left common carotid artery (LCCA) and a middle aortic arch disruption. Surgical reconstruction was accomplished by inserting Dacron prosthesis from the ascending aorta to the LCCA. The aortic arch wound was reconstructed by an autologous pericardial patch. In light of this surgical case, we discuss early methods of diagnosis and details of medical, surgical or endovascular treatments.