Successful Open Repair of Blunt Traumatic Thoracoabdominal Aortic Injury with Concomitant Lumbosacral Fracture–Dislocation

Successful Open Repair of Blunt Traumatic Thoracoabdominal Aortic Injury with Concomitant Lumbosacral Fracture–Dislocation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Successful Open Repair of Blunt Traumatic Thoracoabdominal Aortic Injury with Concomitant Lumbosacral Fracture–Dislocation Yuta Kanazawa, Akihiro Yoshitake, Shota Takaki, Yuko Gatate, Osamu Kinoshita, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7947147/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 Apr, 2026 Read the published version in Journal of Cardiothoracic Surgery → Version 1 posted 15 You are reading this latest preprint version Abstract Background : Although rare, blunt traumatic aortic injury occurs in the aortic isthmus and rarely in the thoracoabdominal aorta. Case presentation : A 56-year-old man became unconscious after falling from the third floor during a suicide attempt. Computed tomography revealed a thoraco-abdominal aortic injury (dissection and pseudo-aneurysm) and a posterior dislocation fracture at L1/L2. Thoraco-abdominal aortic graft replacement was performed 3 d after the injury, and posterior spinal fusion was performed 10 d later. Conclusions : Thoracic endovascular aortic repair is usually performed for blunt traumatic aortic injury of the aortic isthmus; however, open surgery is required for blunt traumatic aortic injury of the thoracoabdominal aorta. blunt traumatic aortic injury open surgery Figures Figure 1 Figure 2 Figure 3 Background Blunt traumatic aortic injury (BTAI) is a rare but life-threatening condition that typically results from a high-energy blunt trauma. BTAI most commonly involves the thoracic aorta, particularly the aortic isthmus, which accounts for approximately 90% of cases. 1 , 2 In contrast, injuries to the thoracoabdominal or abdominal segments of the aorta are exceedingly rare, accounting for < 5% of all BTAIs. 3 In this study, we report the case of an open repair of blunt traumatic thoracoabdominal aortic injury with associated spinal fracture–dislocation and spinal cord injury. Case presentation The patient agreed to publish the case details and images. A 56-year-old man with a history of depression was brought unconscious to our hospital after falling from the third floor during a suicide attempt. The patient was in shock upon arrival at the hospital but quickly recovered following infusion loading. Neurological examination revealed sensory and motor dysfunction in the lower body, and spinal cord injury was strongly suspected. Computed tomography (CT) was performed because of multiple suspected injuries, and the patient was diagnosed with thoracoabdominal aortic injury (Fig. 1 A) and a posterior dislocation fracture at L1/L2 (Fig. 1 B, C). The thoraco-abdominal aortic injury was a dissection and pseudo-aneurysm. The patient was also diagnosed with a hemothorax and multiple rib fractures. After consultation with a spinal surgeon, the decision was made to perform aortic repair first. Treatment with a stent graft was also considered, but due to the lesion's proximity to the abdominal branch and the unavailability of commercial branched stent grafts in Japan, open surgery was selected. The patient’s vital signs were stable, and pain control was adequate. Anemia and hypofibrinogenemia were identified and corrected prior to surgery; hence, thoraco-abdominal aortic graft replacement was performed on the third day after the injury. Unfortunately, the patient's paraplegia was complete, with total loss of motor and sensory function. Therefore, spinal drainage was not performed prior to surgery. The patient was placed in the right-lateral decubitus position. The positioning was carefully planned in collaboration with a spinal surgeon, with particular attention to spinal cord protection. Anesthesia was induced using a standard technique with a double-lumen tube for unilateral ventilation. Peripheral extracorporeal circulation was established via the right femoral artery and veins. A thoracotomy was performed through the eighth intercostal space. The incision was extended caudally, and the aorta was approached retroperitoneally. A large hematoma was present around the abdominal aorta. The fractured spine was identified in the same view (Fig. 2 A). The aorta was clamped to the healthy part via visual examination (proximal Th11 and distal L4). Two slit-like intimal tears were observed in the aorta (Fig. 2 B). Under selective visceral perfusion, graft replacement with a 20-mm 4-branched graft (Gelweave Coselli, Vasctek, Inchinnan, UK) was performed. The postoperative course was uneventful without any complications, and posterior spinal fusion was performed 10 d after the aortic surgery. The general condition of the patient improved after all performed surgeries; however, the spinal cord injury did not improve and paraplegia persisted. One month after injury, the patient was transferred to a hospital for rehabilitation. Postoperative CT images indicated successful replacement of the thoraco-abdominal aorta (Fig. 3 ). Discussion No previous reports on open surgery for thoraco-abdominal BTAI during the acute period are available. BTAI most commonly involves the thoracic aorta, particularly the aortic isthmus, which accounts for approximately 90% of cases. 1 , 2 This anatomical site is uniquely vulnerable because of its relative fixation by the ligamentum arteriosum, which is positioned between the mobile aortic arch and descending thoracic aorta. During rapid deceleration events such as high falls, substantial shear forces are exerted at this transition point, making it the most frequent site of injury. In contrast, injuries involving the thoraco-abdominal or abdominal aorta are very rare, constituting < 5% of BTAI. 3 The abdominal aorta is more mobile and relatively protected by the surrounding viscera and soft tissues, which may dissipate mechanical energy. Thoraco-abdominal aortic injuries, such as in the present case, require strong anterior–posterior compression between the spine and abdominal wall. Thoracic endovascular aortic repair (TEVAR) is usually performed in BTAI of the aortic isthmus. However, BTAI involving the thoraco-abdominal aorta is generally treated by open surgery because endovascular treatment is anatomically difficult due to the frequent proximity of abdominal branches or lumbar arteries to the rupture site. When open surgery is chosen for BTAI, it almost invariably involves hemorrhagic complications; therefore, surgery should be delayed if the patient's general condition permits. 4 In the present case, we waited 3 d after the injury to check for improvement in coagulability before aortic surgery. With advances in device technology, TEVAR may become feasible for treating BTAI of the thoraco-abdominal aorta. However, considering that endoleaks are unacceptable in ruptured cases and that long-term intra-branched stent thrombosis may occur, open surgery remains an important treatment option. Conclusion Herein, we report a rare case of thoraco-abdominal BTAI treated with open surgery. Choosing the appropriate time for open surgery for BTAI is important. Abbreviations BTAI, blunt traumatic aortic injury; CT, computed tomography; TEVAR, thoracic endovascular aortic repair Declarations Presentation information None Acknowledgements The authors would like to thank Editage (www.editage.com) for the English language editing. Funding: None Competing interests: The authors declare that they have no competing interests. Ethics approval and consent to participate: Not applicable Consent for publication: Informed consent was obtained from the patient for the publication of this case in the present article. Availability of data and materials: Not applicable Author’s contributions: YA, YK, and ST performed the surgery. YA was a major contributor to manuscript writing. All the authors have read and approved the final version of the manuscript. References Richens D, Field M, Neale M, Oakley C. The mechanism of injury in blunt traumatic rupture of the aorta. Eur J Cardiothorac Surg. 2002;21:288–93. Starnes BW, Lundgren RS, Gunn M, Quade S, Hatsukami TS. Management of traumatic aortic injury: Thoracic endovascular repair. J Vasc Surg. 2012;55:47–54. Arthurs ZM, Starnes BW. Blunt abdominal aortic injury. J Vasc Surg. 2008;48:651–6. Daniela M, Paolo R. Blunt thoracic aortic injury. J Clin Med. 2023;12:2903. 10.3390/jcm12082903 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 28 Apr, 2026 Read the published version in Journal of Cardiothoracic Surgery → Version 1 posted Editorial decision: Revision requested 25 Mar, 2026 Reviews received at journal 11 Feb, 2026 Reviews received at journal 10 Feb, 2026 Reviews received at journal 30 Jan, 2026 Reviews received at journal 25 Jan, 2026 Reviewers agreed at journal 24 Jan, 2026 Reviewers agreed at journal 22 Jan, 2026 Reviewers agreed at journal 22 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers invited by journal 20 Jan, 2026 Editor assigned by journal 27 Oct, 2025 Submission checks completed at journal 27 Oct, 2025 First submitted to journal 25 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7947147","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":578012810,"identity":"b859952f-b66f-4dcd-9910-e8c483d21af0","order_by":0,"name":"Yuta 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1","display":"","copyAsset":false,"role":"figure","size":126450,"visible":true,"origin":"","legend":"\u003cp\u003ePreoperative CT scan images\u003c/p\u003e\n\u003cp\u003eArrows indicate the thoracoabdominal aorta injury\u003c/p\u003e\n\u003cp\u003eCT, computed tomography\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7947147/v1/4a3f7a82f7d09832eb4607fb.jpg"},{"id":100949861,"identity":"49a497c8-d32d-4f37-9c21-4ab0fc662fb7","added_by":"auto","created_at":"2026-01-23 07:06:03","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":254348,"visible":true,"origin":"","legend":"\u003cp\u003eIntraoperative images (surgeon’s view)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA:\u003c/strong\u003e Arrows indicate the fractured and dislocated spine\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eB:\u003c/strong\u003e Arrows indicate aortic intimal tears\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7947147/v1/e405cb90af9025a882914c5c.jpg"},{"id":100949656,"identity":"e2ef331f-199c-4ec1-b987-b890b9163898","added_by":"auto","created_at":"2026-01-23 07:04:54","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":128754,"visible":true,"origin":"","legend":"\u003cp\u003ePostoperative CT scan images\u003c/p\u003e\n\u003cp\u003eCT, computed tomography\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7947147/v1/a0a3b5c93aafbc6dcfc41b76.jpg"},{"id":108441292,"identity":"271a0493-841d-4bc5-945d-c97fa36edf25","added_by":"auto","created_at":"2026-05-04 16:50:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":629374,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7947147/v1/3925af8e-e457-48e6-984c-b0ab560aee7d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Successful Open Repair of Blunt Traumatic Thoracoabdominal Aortic Injury with Concomitant Lumbosacral Fracture–Dislocation","fulltext":[{"header":"Background","content":"\u003cp\u003eBlunt traumatic aortic injury (BTAI) is a rare but life-threatening condition that typically results from a high-energy blunt trauma. BTAI most commonly involves the thoracic aorta, particularly the aortic isthmus, which accounts for approximately 90% of cases.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e In contrast, injuries to the thoracoabdominal or abdominal segments of the aorta are exceedingly rare, accounting for \u0026lt;\u0026thinsp;5% of all BTAIs.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn this study, we report the case of an open repair of blunt traumatic thoracoabdominal aortic injury with associated spinal fracture\u0026ndash;dislocation and spinal cord injury.\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003e The patient agreed to publish the case details and images.\u003c/p\u003e \u003cp\u003eA 56-year-old man with a history of depression was brought unconscious to our hospital after falling from the third floor during a suicide attempt. The patient was in shock upon arrival at the hospital but quickly recovered following infusion loading. Neurological examination revealed sensory and motor dysfunction in the lower body, and spinal cord injury was strongly suspected.\u003c/p\u003e \u003cp\u003eComputed tomography (CT) was performed because of multiple suspected injuries, and the patient was diagnosed with thoracoabdominal aortic injury (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA) and a posterior dislocation fracture at L1/L2 (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB, C). The thoraco-abdominal aortic injury was a dissection and pseudo-aneurysm. The patient was also diagnosed with a hemothorax and multiple rib fractures. After consultation with a spinal surgeon, the decision was made to perform aortic repair first. Treatment with a stent graft was also considered, but due to the lesion's proximity to the abdominal branch and the unavailability of commercial branched stent grafts in Japan, open surgery was selected.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe patient\u0026rsquo;s vital signs were stable, and pain control was adequate. Anemia and hypofibrinogenemia were identified and corrected prior to surgery; hence, thoraco-abdominal aortic graft replacement was performed on the third day after the injury. Unfortunately, the patient's paraplegia was complete, with total loss of motor and sensory function. Therefore, spinal drainage was not performed prior to surgery.\u003c/p\u003e \u003cp\u003eThe patient was placed in the right-lateral decubitus position. The positioning was carefully planned in collaboration with a spinal surgeon, with particular attention to spinal cord protection. Anesthesia was induced using a standard technique with a double-lumen tube for unilateral ventilation. Peripheral extracorporeal circulation was established via the right femoral artery and veins. A thoracotomy was performed through the eighth intercostal space. The incision was extended caudally, and the aorta was approached retroperitoneally.\u003c/p\u003e \u003cp\u003eA large hematoma was present around the abdominal aorta. The fractured spine was identified in the same view (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). The aorta was clamped to the healthy part via visual examination (proximal Th11 and distal L4). Two slit-like intimal tears were observed in the aorta (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). Under selective visceral perfusion, graft replacement with a 20-mm 4-branched graft (Gelweave Coselli, Vasctek, Inchinnan, UK) was performed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe postoperative course was uneventful without any complications, and posterior spinal fusion was performed 10 d after the aortic surgery. The general condition of the patient improved after all performed surgeries; however, the spinal cord injury did not improve and paraplegia persisted.\u003c/p\u003e \u003cp\u003eOne month after injury, the patient was transferred to a hospital for rehabilitation. Postoperative CT images indicated successful replacement of the thoraco-abdominal aorta (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eNo previous reports on open surgery for thoraco-abdominal BTAI during the acute period are available. BTAI most commonly involves the thoracic aorta, particularly the aortic isthmus, which accounts for approximately 90% of cases.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e This anatomical site is uniquely vulnerable because of its relative fixation by the ligamentum arteriosum, which is positioned between the mobile aortic arch and descending thoracic aorta. During rapid deceleration events such as high falls, substantial shear forces are exerted at this transition point, making it the most frequent site of injury. In contrast, injuries involving the thoraco-abdominal or abdominal aorta are very rare, constituting\u0026thinsp;\u0026lt;\u0026thinsp;5% of BTAI.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e The abdominal aorta is more mobile and relatively protected by the surrounding viscera and soft tissues, which may dissipate mechanical energy.\u003c/p\u003e \u003cp\u003eThoraco-abdominal aortic injuries, such as in the present case, require strong anterior\u0026ndash;posterior compression between the spine and abdominal wall. Thoracic endovascular aortic repair (TEVAR) is usually performed in BTAI of the aortic isthmus. However, BTAI involving the thoraco-abdominal aorta is generally treated by open surgery because endovascular treatment is anatomically difficult due to the frequent proximity of abdominal branches or lumbar arteries to the rupture site. When open surgery is chosen for BTAI, it almost invariably involves hemorrhagic complications; therefore, surgery should be delayed if the patient's general condition permits.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e In the present case, we waited 3 d after the injury to check for improvement in coagulability before aortic surgery. With advances in device technology, TEVAR may become feasible for treating BTAI of the thoraco-abdominal aorta. However, considering that endoleaks are unacceptable in ruptured cases and that long-term intra-branched stent thrombosis may occur, open surgery remains an important treatment option.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eHerein, we report a rare case of thoraco-abdominal BTAI treated with open surgery. Choosing the appropriate time for open surgery for BTAI is important.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBTAI, blunt traumatic aortic injury; CT, computed tomography; TEVAR, thoracic endovascular aortic repair\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003ePresentation information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Editage (www.editage.com) for the English language editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from the patient for the publication of this case in the present article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYA, YK, and ST performed the surgery. YA was a major contributor to manuscript writing. All the authors have read and approved the final version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRichens D, Field M, Neale M, Oakley C. The mechanism of injury in blunt traumatic rupture of the aorta. Eur J Cardiothorac Surg. 2002;21:288\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStarnes BW, Lundgren RS, Gunn M, Quade S, Hatsukami TS. Management of traumatic aortic injury: Thoracic endovascular repair. J Vasc Surg. 2012;55:47\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArthurs ZM, Starnes BW. Blunt abdominal aortic injury. J Vasc Surg. 2008;48:651\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaniela M, Paolo R. Blunt thoracic aortic injury. J Clin Med. 2023;12:2903. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jcm12082903\u003c/span\u003e\u003cspan address=\"10.3390/jcm12082903\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-cardiothoracic-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jcts","sideBox":"Learn more about [Journal of Cardiothoracic Surgery](http://cardiothoracicsurgery.biomedcentral.com)","snPcode":"13019","submissionUrl":"https://submission.nature.com/new-submission/13019/3","title":"Journal of Cardiothoracic Surgery","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"blunt traumatic aortic injury, open surgery","lastPublishedDoi":"10.21203/rs.3.rs-7947147/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7947147/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Although rare, blunt traumatic aortic injury occurs in the aortic isthmus and rarely in the thoracoabdominal aorta.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e:\u003cstrong\u003e \u003c/strong\u003eA 56-year-old man became unconscious after falling from the third floor during a suicide attempt. Computed tomography revealed a thoraco-abdominal aortic injury (dissection and pseudo-aneurysm) and a posterior dislocation fracture at L1/L2. Thoraco-abdominal aortic graft replacement was performed 3 d after the injury, and posterior spinal fusion was performed 10 d later.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e:\u003cstrong\u003e \u003c/strong\u003eThoracic endovascular aortic repair is usually performed for blunt traumatic aortic injury of the aortic isthmus; however, open surgery is required for blunt traumatic aortic injury of the thoracoabdominal aorta.\u003c/p\u003e","manuscriptTitle":"Successful Open Repair of Blunt Traumatic Thoracoabdominal Aortic Injury with Concomitant Lumbosacral Fracture–Dislocation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-22 08:32:50","doi":"10.21203/rs.3.rs-7947147/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-25T18:21:47+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-11T12:48:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-10T05:09:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-31T03:51:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-25T10:52:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135427206760814589097136689355807591111","date":"2026-01-24T07:08:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"25928320264694598125363434626115651776","date":"2026-01-23T01:10:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"169735666705261260857689335527448627824","date":"2026-01-22T10:39:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"42827924388114770573752058134409309335","date":"2026-01-21T02:30:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"29283799466926086174717722766352453865","date":"2026-01-20T17:00:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"337139069779689101195089380464458056037","date":"2026-01-20T16:59:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-20T16:37:20+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-27T07:11:07+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-27T07:08:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Cardiothoracic Surgery","date":"2025-10-25T13:53:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-cardiothoracic-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jcts","sideBox":"Learn more about [Journal of Cardiothoracic Surgery](http://cardiothoracicsurgery.biomedcentral.com)","snPcode":"13019","submissionUrl":"https://submission.nature.com/new-submission/13019/3","title":"Journal of Cardiothoracic Surgery","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7b35033c-3596-4821-b1a9-8fe801137a09","owner":[],"postedDate":"January 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T16:50:21+00:00","versionOfRecord":{"articleIdentity":"rs-7947147","link":"https://doi.org/10.1186/s13019-026-04138-1","journal":{"identity":"journal-of-cardiothoracic-surgery","isVorOnly":false,"title":"Journal of Cardiothoracic Surgery"},"publishedOn":"2026-04-28 15:58:02","publishedOnDateReadable":"April 28th, 2026"},"versionCreatedAt":"2026-01-22 08:32:50","video":"","vorDoi":"10.1186/s13019-026-04138-1","vorDoiUrl":"https://doi.org/10.1186/s13019-026-04138-1","workflowStages":[]},"version":"v1","identity":"rs-7947147","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7947147","identity":"rs-7947147","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}