Traumatic aortic aneurysm: graftless excision, anastomosis.

Traumatic aneurysms of the thoracic aorta differ from arteriosclerotic and leutic aneurysms in several important respects. Typically, in the former, the patient is healthy and the aneurysm arises from a linear, transverse disruption of the intima and media, 1 with no significant loss of adjacent normal vessel, in contradistinction to the latter, where diffuse disease of the aorta is generally present. Hence, logically, traumatic aneurysms should often be susceptible of excision with restoration of aortic continuity by direct anastomosis. A review of the literature reveals, however, that the same principles of resection and grafting inherently necessary in the management of aneurysms due to diffuse vascular disease, have been customarily employed in the surgical treatment of traumatic aneurysms. 2-4 The purpose of this report is to present a case of traumatic aneurysm treated by excision and direct aortic anastomosis employing left atrial-femoral artery bypass during the period of aortic occlusion. Aortic