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The Annals of Thoracic Surgery, Vol 35, 579-583, Copyright © 1983 by The Society of Thoracic Surgeons

ARTICLES

Bypass grafting and aneurysmorrhaphy for aortic arch aneurysms

HC Urschel Jr, MA Razzuk and AC Leshnower

The technique of permanent aortic arch bypass grafting combined with simultaneous aneurysmorrhaphy, excision or exclusion of the aneurysm without the use of systemic heparinization, cardiopulmonary bypass, or external bypass shunting has been used successfully in treating 5 patients with aneurysms of the aortic arch. There were no complicating cerebral vascular accidents, bleeding diatheses, or signs of distal embolization. There were 2 deaths; 1 patient died early (10 days postoperatively) of myocardial infarction, and the other died over one year later of unrelated causes. Follow-up has extended to an interval of seven years. The early death subsequent to myocardial infarction in 1 patient prompted the routine use of preoperative carotid and coronary angiography for assessment of these systems. Severe occlusive disease in these vessels requires a staged or simultaneous reconstruction prior to management of the aortic aneurysm.

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