American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the preferred intervention for aortic transection?

1. Right thoracotomy

2. Covered stent graft

3. Anterior mediastinal approach

4. Conservative management

The correct answer is: Covered stent graft

The preferred intervention for aortic transection is the use of a covered stent graft. Aortic transection, often resulting from high-velocity trauma, can lead to rapid hemorrhage and significant morbidity. The use of a covered stent graft allows for less invasive intervention compared to traditional surgical approaches, such as thoracotomy. Covered stent grafts provide a pathway for the blood to flow while sealing off the tear or injury in the aorta, significantly reducing the risk of complications associated with open surgery. This method is especially advantageous in the urgent settings, as it can be performed endovascularly and often under local anesthesia, minimizing the physiological stress on the patient. While other interventions may have roles in specific scenarios, none offer the combination of effective repair with minimal morbidity that a covered stent graft provides for this condition. It’s essential to consider factors such as the location of the transection, the patient's overall condition, and the availability of endovascular resources when choosing the treatment.