Surgical treatment of thoracic aneurysm: a 5-year experience.

The surgical results of 77 patients with an aneurysm of the thoracic or thoracoabdominal aorta who were surgically treated during a 5-year period were retrospectively evaluated. Eighty-four operations were performed. The aneurysm was located on the ascending aorta in 20 patients, on the arch in nine, and on the arch and ascending aorta in eight. Sixteen aneurysms involved the descending thoracic aorta and 27 were thoracoabdominal. Associated surgery was performed in 12 patients. Deep hypothermia and circulatory arrest were employed in 30 patients. Partial cardiopulmonary bypass was used in 15 patients. Mortality was significantly higher if operation was performed under emergency conditions: the early mortality rate was 11.7%. Aggressive surgical management of untreated aneurysm is justified, as rupture of such lesions is the most common cause of death and associated mortality is high, with a 5-year survival rate of less than 20%.