Resection of aortic arch aneurysm: a simplified technique.

Aortic arch aneurysm has long been considered one of the most serious diseases in the circulatory system, and its resection is associated with great technical difficulties and hazardous consequences. Temporary shunts created with multiple graft anastomoses, deep hypothermia, progressive insertion of the graft, and cardiopulmonary bypass have been used to facilitate resection of the aneurysm at this vital segment of aorta. However, all of these techniques have certain disadvantages. To circumvent these disadvantages, we are proposing a simplified technique of external shunting combined with a permanent bypass graft. This method was used successfully in resection of a syphilitic aneurysm of the transverse aortic arch. The new technique is simple and easy to set up, and it greatly facilitates resection and graft replacement of the aneurysm. Because it does not require a pump oxygenator for bypass, it eliminates the postoperative blood coagulation problem. This technique is considered to be applicable in resection of aneurysms of the descending thoracic aorta as well.