Study of Potential Mechanisms of Traumatic Rupture of the Aorta Using <italic>InSitu</italic> Experiments

Traumatic rupture of the aorta (TRA) is an important transportation-related injury. This study investigated TRA mechanisms using in situ human cadaver experiments. Four quasi-static tests and one dynamic test were performed. The quasi-static experiments were conducted by perturbing the mediastinal structures of the cadavers. The mechanisms investigated included anterior, superior, and lateral displacement of the heart and aortic arch. The resulting injuries ranged from partial tears to complete transections. All injuries occurred within the peri-isthmic region. Intimal tears were associated with the primary injuries. The average failure load and stretch were 148 N and 30 percent for the quasi-static tests. This study illustrates that TRA can result from appropriate application of nominal levels of longitudinal load and tension. The results demonstrate that intraluminal pressure and whole-body acceleration are not required for TRA to occur. The results suggest that the role of the ligamentum arteriosum is likely limited, and that TRA can occur in the absence of pulmonary artery injury. Tethering of the descending thoracic aorta by the parietal pleura is a principal aspect of this injury.