[The treatment of patients with distal arch aneurysms--hypothermic circulatory arrest and left posterolateral exposure].

In ten patients we treated with distal arch aneurysms exposed through left posterolateral incisions, we induced profound hypothermia and circulatory arrest. Before circulatory arrest, thiopental, nicardipine and glycerol were used to protect the brain. The brain function was objectively evaluated through continuous recording of EEG and PO2 tension of the internal jugular vein. A cardiopulmonary bypass was introduced via the left atrium, pulmonary artery and left femoral artery cannulation. After proximal anastomosis between the graft and transverse aorta, graft cannulation was added. The distal aortic arch was replaced in all patients, with the entire descending thoracic aorta additionally replaced in two. No patients died in hospital. Two suffered neurological deficit, i.e., one having slight memory impairment and the other having a left-sided stroke due to right cerebral infarction, but recovering completely within a week. Our results indicate that profound hypothermia and circulatory arrest can be implemented safely when treating patients with distal arch aneurysm.