What Is an Aortic Rupture?

Types of Aortic Ruptures

Aortic ruptures are classified into two main types:

• Aortic rupture secondary to aortic aneurysm
• Traumatic aortic rupture

Aortic Aneurysm Secondary to Aortic Aneurysm

An aortic aneurysm is a bulge that forms in the wall of the aorta. Aortic aneurysms can occur anywhere in the aorta and may be round (saccular) or tube-shaped (fusiform). Larger aortic aneurysms are at risk to rupture or burst, causing massive internal bleeding that is usually fatal. Ideally, aortic aneurysms get repaired before a rupture can occur. Learn more about how the skilled heart and vascular specialists at University Hospitals Harrington Heart & Vascular Institute diagnose and repair aortic aneurysms.

Traumatic Aortic Rupture

A traumatic aortic rupture, also called a traumatic aortic transection, occurs due to trauma to the aorta, such as that caused by a penetrating injury or during a motor vehicle accident.

Symptoms of Traumatic Aortic Rupture

When a traumatic aortic rupture occurs, it can cause the following symptoms:

• Severe chest pain
• Severe abdominal pain
• Severe back pain
• Difficulty breathing
• Pain at the site of injury
• Shock

Signs of external chest injury may also accompany the condition.

Diagnosis of Traumatic Aortic Rupture

Aortic ruptures are almost always diagnosed in the emergency room following a traumatic event. In most cases, the condition is not discovered until imaging tests are performed. Imaging tests used to view the aorta and check for the presence of a tear include:

• Computed tomography scan (CT): A CT scan creates cross-sectional images of the body using x-ray imaging technology.
• Magnetic resonance angiography (MRA): A type of magnetic resonance imaging specifically designed to look at blood vessels.
• Aortic angiogram: This procedure uses a special dye and x-rays to see how blood flows through the aorta.
• Transesophageal echocardiography: In this test, an ultrasound probe is inserted through the esophagus to view the aorta using high-frequency sound waves.

Treatment of a Traumatic Aortic Rupture

Because traumatic aortic rupture is a life-threatening condition, immediate treatment is required. The most common treatment is endovascular repair of the damaged area. Endovascular repair is a minimally invasive alternative to open surgery because it does not require a large incision. During the procedure, the surgical team uses a catheter-based technique to fix the aorta with the assistance of special X-ray technology.

Less often, open surgery will be used to fix the damaged aorta. In this procedure, a surgeon removes the damaged portion of the aorta, replacing the removed portion with a graft (a tube usually made of synthetic material) in order to stop blood leakage and restore function to the injured area.