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Eur J Cardiothorac Surg 2002;21:288-293
© 2002 Elsevier Science NL

Review

The mechanism of injury in blunt traumatic rupture of the aorta

^a Department of Cardiothoracic Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
^b Transport Research Laboratory, Crowthorne, UK

Received 31 May 2001; received in revised form 2 November 2001; accepted 12 November 2001.

* Corresponding author. Tel.: +44-115-969-1169; fax: +44-115-840-2605
e-mail: drichens{at}ncht.trent.nhs.uk

Rupture of the aorta accounts for a significant proportion of fatalities following blunt trauma. A great deal of consensus exists describing the circumstances under which acute traumatic aortic dissection occurs as well as its investigation and management. However, there remains some controversy surrounding the pathogenic aetiology underlying this injury. Univariate and multivariate models of blunt traumatic aortic rupture (BTAR) are discussed. To account for the consistency in the nature of BTAR, despite a range of trauma scenarios, the concepts of dynamic multivariate models and a final common pathway are introduced. Clinical management is described elsewhere. Greater understanding of the mechanism of BTAR could lead to a range of safety systems aimed at a reduction in its incidence and severity.

Key Words: Blunt trauma • Aortic rupture • Survival • Safety

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