Use of the balloon catheter for distal occlusion of the aorta in prosthetic replacement of aortic arch aneurysms.

A balloon catheter was utilized to occlude the distal aorta during prosthetic replacement of an aortic arch aneurysm in 4 consecutive patients under conditions of separate cerebral and peripheral perfusion and deep hypothermia. All patients survived the procedure, and 3 were doing well 1 to 1.5 years following operation. One patient sustained a cerebral infarction and recovered with some sequent disability. The use of a balloon occlusion catheter allowed us to perform the operation through a median sternotomy only, and eliminated the procedure of pulmonary dissection for distal clamping and the risk of emboli. In addition, its use provided a relatively bloodless field and sufficient protection for organs in the lower body through adequate perfusion, even when their function was poor or when the distal anastomosis was prolonged. We realized improved surgical results in the treatment of aneurysms of the aortic arch.