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J Thorac Cardiovasc Surg 2004;128:632-634
© 2004 The American Association for Thoracic Surgery

Brief communication

Innominate artery transection in the setting of a bovine arch

^a Department of Surgery, Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa, USA
^b Department of Surgery, Division of Traumatology, Hospital of the University of Pennsylvania, Philadelphia, Pa, USA

Received for publication February 16, 2004; revisions received March 8, 2004; accepted for publication March 18, 2004.

^* Address for reprints: Y. Joseph Woo, MD, Department of Surgery, Division of Cardiothoracic Surgery, 6th Floor, Silverstein Building, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA
wooy@uphs.upenn.edu

The first 20% of the full text of this article appears below.

Blunt trauma to the innominate artery is an infrequent but commonly fatal occurrence. We report a case of a patient with a bovine arch who underwent successful graft replacement of the innominate artery and reconstruction of the aortic arch under deep hypothermic circulatory arrest with retrograde cerebral perfusion.

Clinical summary

A 46-year-old woman was brought to our trauma bay intubated and with stable hemodynamics after a head-on motor vehicle collision. A chest x-ray film showed a widened mediastinum. A subsequent computed tomographic scan of the chest and aortogram revealed a contained traumatic pseudoaneurysm of the innominate artery in the setting of the bovine arch anatomy (Figure 1). The patient also had a grade III liver laceration, bilateral rib fractures leading to bilateral pneumothoraces, and multiple lower extremity orthopedic injuries. She was taken on an emergency basis to the operating room. An external fixation device was placed to stabilize the right femur and to prevent further blood loss in that compartment. A baseline abdominal flow-assisted short-term ultrasound examination . . . [Full Text of this Article]

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