Outcome of thoracoabdominal aortic aneurysm surgery. Analysis of 27 consecutive cases.

Twenty seven patients underwent repair of a thoracoabdominal aortic aneurysm at our hospital during 1978-1993. Sixteen were elective and 11 emergencies. We used a temporary shunt and transsection of the proximal aorta between vascular clamps, so that the whole distal aorta with its branches was perfused through the shunt during suturing of the proximal anastomosis. The aortic branch arteries were revascularized by the step by step technique. Hospital mortality was 6/27 (22%) and two and five-year cumulative survival rates 74% and 52%. Late deaths were not related to aneurysm disease. Paraplegia developed in two patients. Distal aortic perfusion was used as a means of spinal cord preservation.