An update of treatment of aneurysms of the descending thoracic aorta

Excisional therapy has been employed in 32 patients with fusiform aneurysms of the descending aorta. Based on the addition of one of the bypass techniques employed to minimize the hemodynamic abnormalities of aortic clamping, the series is divided into 2 groups, each comprised of 16 patients. In Group I either extracorporeal circulation or indwelling temporary shunts were employed during the period of aortic occlusion, while in Group II simple aortic cross‐clamping was utilized to manage the lesion. No adjuncts were used to avoid ischemia in the latter group. The only death and 2 instances of paraplegia occurred in the shunt group. In general, there were fewer complications in the no‐shunt group, with approximately 2/3 of the patients experiencing an uncomplicated postoperative course. These differences are considered significant, since the 2 groups were similar in respect to the extent and nature of the lesions and other factors influencing operative risk.