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Tue Mar 20 21:10:40 GMT 2007

26 y.o. male in MVC presents, in hemodynamically stable condition, 2 hrs after trauma, with TA transection:

1)  No, Dr. Mattox, a confirmatory angio was not done (not my case, I would have): it is diagnosed on CTA of chest with recons.  Distal to takeoff of L subclavian.

2)  Beta-blockers given

3)  We are a level I center and have talented CT surgeons w/ OR available.

Would it be considered appropriate by any list members to put this young man in another helicopter and fly him to a "Heart Hospital" 162 ground (141 nautical) miles away for a thoracic Ao stent?

>From what I'm picking up at the meetings, if stable, sit on them in the ICU...on beta blockers...if not, go to OR and clamp/sew.  I'm not disagreeing, totally, with TA stent, though my experience is limited (I have seen one get infected).  But, isn't it risky to send him off to a non-trauma center to do this?

I'm not a CT surgeon.  What would YOU do?

Thanks
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Thoracic Ao Transection