The Annals of Thoracic Surgery, Vol 57, 1040-1042, Copyright © 1994 by The Society of Thoracic Surgeons
Resection of aortic arch aneurysms using an external shunt
RR Klingman and VA Ferraris
Queen of the Valley Hospital, Napa, California.
Surgical treatment of aneurysms of the thoracic aorta had its beginnings in
the early 1950s. At that time, thoracic aneurysms were usually due to
syphilitic infection and were usually fatal. Before the development of the
heart-lung machine, it was realized that external shunts could facilitate
the repair of these aneurysms. In 1954, Dr Ralph Alley and his colleagues
at Albany Medical Center reported 2 patients who had surgical correction of
thoracic aortic aneurysms using external vascular shunts. Both bovine
aortic heterograft and human aortic homograft were used as aortic
substitutes. These patients were presented at the Thirty-fourth Annual
Meeting of the American Association for Thoracic Surgery in Montreal,
Quebec, in May 1954, and case reports were subsequently published in the
Journal of Thoracic Surgery in 1955. These presentations served as the
stimulus for subsequent clinical studies and laboratory research,
eventually leading to a better understanding of the physiologic principles
involved in clamping the thoracic aorta. Doctor Alley's article is a
classic in the field of cardiothoracic surgery and is now reviewed 39 years
after its publication.
