Experience with Thirteen Cases of Resection of Aneurysms of the Descending Thoracic Aorta
THE fifteen years since the end of World War II have seen an unprecedented extension of knowledge and development of technics in virtually all fields of surgery. In no area has this development been more dramatic than in that of surgery of the great vessels. In this brief time, for all practical purposes, is encompassed the entire history of aortic surgery as we know it today. This paper discusses surgical experience with aneurysms in the descending thoracic aorta. Ten years ago, such aneurysms were hopeless problems and eventually were fatal. Now, definitive surgical cure is possible.
Many surgeons have made significant contributions to this field; however, the major credit for the technics described in this paper must go solely to the surgical group in Houston, Texas, under the leadership of Dr. Michael E. DeBakey. Each important phase of the technics described has been reported in every essential detail by this group.1,2
Surgical resection for coarctation of the aorta, a procedure that is now more than 15 years of age, first established the feasibility of anastomotic procedures on this vessel; but resection, with either direct anastomosis or insertion of a graft, for coarctation differs from resection for aneurysm in one basic condition—the patient with coarctation is born with his aorta “clamped,” and with excellent collaterals around the obstruction. He thus can tolerate additional clamping of this area of the aorta for unhurried anastomotic procedures without significant hazard of ischemic problems to the spinal cord or to other vital organs distally . . .