1206 Emergency Repair of a Traumatic Carotid Artery Rupture in a Bovine-Type Aortic Arch: A Case Study

This joint vascular and cardiac case relates to a 14-year-old female who was involved in a pedestrian versus car collision and suffered polytraumatic injuries, the most life threatening of which was a tear to the base of the left common carotid artery (LCCA). This case became unique upon discovering the presence of a bovine-type aortic arch which limited endovascular options and led to the requirement of a surgical approach with cardiopulmonary bypass support. The bovine-type arch with a proximal LCCA take-off had implications in surgical planning including the need for cardiopulmonary bypass support due to challenging clamp placement to ensure both cerebral and cardiac protection. This case presented challenges from both a cardiac and vascular perspective, due to atypical anatomy, patient size and uncertainty in an emergency scenario which led to multidisciplinary discussion and preparation for various surgical approaches.